先天性十二指肠隔膜型肠梗阻诊治分析

The diagnosis and treatment of congenital duodenal diaphragmatic obstruction.

目的总结先天性十二指肠隔膜型肠梗阻的诊治经验。方法回顾性分析2003年1月至2011年10月作者收治的33例先天性十二指肠隔膜型肠梗阻患儿临床资料。结果十二指肠隔膜型闭锁8例，风袋型隔膜闭锁4例，隔膜型狭窄11例，风袋型隔膜狭窄9例。行隔膜切除、十二指肠纵切横缝术29例；十二指肠十二指肠吻合术4例。治愈32例，死亡1例。术后随访3个月至8年，患儿均生长发育良好。结论十二指肠隔膜型肠梗阻可早期诊断。隔膜切除、十二指肠纵切横缝术是较为可靠的治疗方法。术中应注意隔膜的探查和处理，同时加强围手术期综合治疗。

Objective To summarize the experience in the diagnosis and treatment of congenital duode- nal diaphragmatic obstruction. Methods From January 2003 to October 2011, the data of 33 cases with con- genital duodenal diaphragm were retrospectively analyzed. Results 8 cases were ascertained with the simple duodenal membranous atresia, 4 with the wind-bag diaphragm, 11 with the simple diaphragmatic stenosis and 9 with the wind-bag diaphragmatic stenosis. 29 cases were underwent a diaphragm resection and 4 cases were performed a duodenoduodenostomy. Cured 32 cases 1 died. On follow-up of 3 months to 8 years, the growth and development were well. Conclusion Congenital duodenal obstruction due to the diaphragm could be early di- agnosed. The diaphragmatic resection and/or duodenoduodenostomy is a more reliable prodedure. The explora- tion for the diaphragmatic types is an important point and the peri-operative treatment must be strengthened.