先天性肠闭锁病理组织学研究

Pathohistological changes in congenital intestinal atresia

目的:分析先天性肠闭锁的病理组织学改变及其对肠道功能的影响,以探讨肠闭锁手术的切除范围。方法:对16例先天性肠闭锁手术切除之远近端肠管行 HE 染色,光镜下观察肠壁各层厚度及神经组织的改变及其范围。结果:在各型肠闭锁中,远近端肠管除肠壁厚度有改变外,各层神经丛及神经节细胞数均较正常明显减少,近端改变范围大于10cm,远端改变局限于2cm 内。在此范围内,随着远离闭锁盲端,上述指标均有逐渐增加的趋势。结论:本组结果从病理角度上对肠闭锁手术切除范围提供了理论依据,并对术后肠道功能恢复缓慢的现象给予解释。提出肠闭锁术后应依据具体情况合理延长 TPN 时间,以期患儿安全度过肠道功能自我逆转期。

Objective:To study pathohistological changes in congenital intestinal atresia as the reference of surigical resection.Methods:Sixteen cases of congenital intestinal atresia were stud- ied.The specimens were taken from the resected intestinal segments proximal and distal to the a- tresia.The sections were stained with haematoxylin and eosin,and examined under light micro- scope.Results:The submucosal plexus,myenteric plexus and ganglionic cells decreased in num- ber at both ends of the atresia on the thickened intestinal wall.These changes extended 10 cm proximally and 2 cm distally from the blind end,and showed a tendency on the increase at the far- ther and of atresia.Conclusions:The above mentioned changes explain the postoperative intestinal disorders.The extent of intestinal resection is suggested.Total parenteral nutrition must be pro- vided for the recovery of the effective intestinal function with a period of time after operation.