应用胃管初步诊断先天性食管闭锁

Preliminary diagnosis of congenital atresia of esophagus by stomach pipe

目的 :探讨应用胃管初步诊断先天性食管闭锁的可行性及操作程序。方法 :观察 18例食管闭锁患儿放置胃管的过程 ,总结术中出现的异常情况。结果 :18例患儿放置胃管过程中均发现异常 :出现阻力 17例 ,反复盘曲、回返至口腔 6例 ,插入 10cm左右抽吸有液体者 9例 ,注入空气 10ml同时胃部听诊 18例均未闻及气过水声 ,胸骨上段听诊闻及气过水声 8例 ,空气快速注入时口鼻处气流溢出 4例 ,注入温开水从口鼻返流 16例。结论 :通过规范的操作和严格的观察 ,可利用胃管放置对先天性食管闭锁进行初步诊断 ,从而减少对该病的误诊率。

Objective: To discuss the feasibility and operation sequence for congenital atresia of esophagus by stomach pipe. Methods: To observe the process of sending out stomach pipe in 18 cases of congenital atresia of esophagus and summarize abnormal phenomena. Results: Abnormal phenomena were observed in the process of sending out stomach in 18 case of congenital atresia of esophagus.17cases with obstruction, 6 cases with twist and return to oral cavity. There were 9 patients who liquid could be absorbed in the depth of 10 centimeters. As injecting 10 milliliters air into the stomach, all of the 18 patients could not be auscultated the sound of air passing through water at stomachic region, and 8 patients could be auscultated the sound at the upper part of the breastbone. Meanwhile 4 patients had air stream overflow when we injected air into the stomach quickly and 16 patients had warm water return to oral cavity and nasal cavity when we injected warm water. Conclusion: Standard operation and strict observation would be benefit in congenital atresia of esophagus and reducing the rate of erroneous diagnosis.