危重型脐膨出

Critical omphalocele

目的 探讨影响脐膨出预后的因素，评价治疗效果。方法 对３７ 例脐膨出婴儿进行回顾性研究和总结。危重型脐膨出２７ 例，其中巨大脐膨出（ 直径６ ｃｍ 以上）２１ 例，缺损直径小于５ ｃｍ者６ 例。结果 全组治愈２６ 例（７０ ．２７ ％ ），其中危重型治愈１９ 例（１９／２７） ；巨大脐膨出治愈１６ 例（１６／２１） ；一期修补２９ 例，治愈２５ 例（８６．２ ％ ）；有呼吸机支持组治愈率为８５ ．７ ％ ，无呼吸机支持组治愈率为５６．２５ ％ 。结论 危重型脐膨出与预后有密切关系，包括巨大脐膨出、出生时呼吸窘迫（ＲＤ）、囊膜破裂和致死性畸形。不应过分强调缺损大小，而应重视危重状态。有效和足够时间的呼吸支持极为重要。

Objective To evaluate the prognostic factors and therapeutic results of omphalocele.Methods The records of 37 neonates with omphalocele were reviewed and analysed. Critical omphalocele was defined as neonates with giant omphalocele (diameter>6cm), respiratory distress, membrane rupture or fatal anomalies.Results Of them, 27 cases suffered from the critical type. The overall survival rate was 70.27% (26/37). The survival rate of the critical type was 70.37% (19/27). The Survival rate of neonates who undervent primary closure was 86.2% (25/29) and of those with and without respiratory support were 85.7% and 56.25% respectively.Conclusions The size of the defect should not be overemphasized. Adequate respiratory support is more relevant to the prognosis.