近回盲瓣回肠吻合应用于新生儿和婴儿急症的探讨

Terminal ileoileostomy to save the adjacent ileocecal valve in neonates suffering from acute abdomen

目的探讨近回盲瓣回肠端端吻合术应用于新生儿和婴儿急症的可行性和安全性。方法对2003-2006年行近回盲瓣回肠（末端回肠距回盲瓣10cm以内）端端吻合术的15例新生儿和婴儿急症患者的临床资料进行回顾性分析。结果本组15例中回肠吻合口距回盲瓣均在10cm以内，其中5cm以内9例。1例残留小肠约40cm者术后当日即自动出院，另14例均痊愈出院，平均住院10．5d。仅1例发生切口感染，未发生吻合口漏等并发症。结论对新生儿和婴儿具有重要功能的尚未被病变累及的回盲部可采用近回盲瓣回肠端端吻合术，辅助肠减压手术多无必要。

Objective To investigate the feasibility and safety of ileoileostomy on the region adjacent to ileocecal valve for the treatment of acute abdomen in neonates, Methods Fifteen newborn acute abdomen cases between 2003 and 2006 treated with ileectomy close to ileocecal valve （less than 10 cm） and ileoileostomy were analysed retrospectively. Results The length from anastomotic stoma to ileocecal valve was less than 10 cm in all cases, and less than 5 cm in 9 cases, One case died perioperatively, and the recovery was uneventful in the remaining 14 cases except for minor incision inflammation in one case. The average hospital stay was 10. 5 days. Conclusions In neonates terminal ileum is often subject to acute intussusception, right strangulated oblique inguinal hernia, intestinal atresia and compression of fibrous-string which sometimes necessitate ileectomy, To preserve ileocecal valve important to neonates physiology ileoileostomy close to ileocecal valve has to be fashioned, Our experience has shown that this is a safe procedure without the need of odditional decompression of the proximal intestine,