先天性肠闭锁16例治疗体会

Therapeutic understand for 16 patients with congenital intestinal atresia

目的总结先天性肠闭锁的治疗体会。方法回顾性分析16例先天性肠闭锁患儿临床资料,其中十二指肠闭锁1例,空肠闭锁8例,回肠闭锁6例,结肠闭锁1例;Ⅰ型3例,Ⅲ型13例;行十二指肠-空肠侧侧菱形吻合1例,隔膜切除肠管纵切横缝1例,闭锁肠段肠切除端斜吻合14例。结果1例术后第6天出现吻合口瘘后弃医,治愈15例,治愈率93.75%。结论早期手术和选择合理的术式可提高治愈率;术后禁食2周,全胃肠外营养,有利于吻合口愈合;早期石蜡油灌肠有利于肠蠕动恢复。

Objective：To summarize the experience of treatment of eongenital intestinal atresia. Methods：The clinical data of 16 patients with congenital intestinal atresia were reviewed ,including one patient with duodenal atresia,eight patients with jejunal atresia, 6 patients with ileum atresia and one patient with colonic atresia. There were 3 patients with type I atresia and 13 patients with type m. One patient, was treated with diamond duodeno-jejunalstomy,one underwent septum resection and then longitudinal anastomosis, and 14 underwent end-to-back anastomosis. Results：The treatment for one patient gave up postoperatively after anastomatic leakage while 15 were cured with the cure rate up to 93.75%. Conclusions： Early operation and the appropriate surgical procedures are crucial to improve the cure rate. The postoperative fasting for 2 week and total parenteral nutrition management are favorable for healing. The paraffinum enema helps intestinal peristalsis.