先天性肠闭锁／狭窄病变部位与预后关系的探讨

Association between lesion site and prognosis in neonates with intestinal atresia/stenosis.

目的探讨特殊部位的肠闭锁／狭窄手术方法与预后的关系。方法回顾性分析本院自2006年6月至2011年6月收治的145例因肠闭锁／狭窄而行手术治疗的患儿临床资料，其中十二指肠闭锁／狭窄36例，空肠闭锁／狭窄46例，回肠闭锁／狭窄59例，结肠闭锁／狭窄4例。145例中，距屈氏韧带约20cm以内的肠闭锁／狭窄3l例，距回盲部20am以内的回肠闭锁／狭窄19例。结果总病死率为12．41％，术后并发症的总发生率为21．13％。距回盲部20cm以内的回肠闭锁／狭窄患儿术后并发症的发生率明显高于术后并发症的总发生率（P〈0．05）。结论末端回肠和结肠闭锁术后并发症的发生率高，先天性肠闭锁／狭窄的治疗强调围手术期的正确处理。

Objetive To discusses the accociation between the surgical approach and prognosis of the special site of intestinal atresia/stenosis. Methods We reviewed clinical data of 145 cases who underwent surgery because of intestinal atresia/stenosis from June 2006 to June 2011, among them, 36 were duodenum atresia/stenosis, 46 were jejunum atresia/stenosis, 59 were ileal atresia/stenosis, 4 were colon atresia/steno- sis. In 31 cases, the lesion sites were 20 centimeter away from Treitz~ ligament, while in another 19 cases, the lesions were within 20 cm to the ileocecus. Results The total mortality was 12.41%, total postoperative com- plication rate was 21.13%. The postoperative complication rate in the cases of terminal ileal atresia/stenosis was significantly higher than the total postoperative complication rate （ P 〈 0.05 ）. Conclusions The postoper- ative complication rate in the cases of terminal ileal and the colon intestinal atresia/stenosis were higher, it should be handled properly in these cases.