生物组织补片修补先天性腹裂9例

Biological tissue patch repair gastroschisis report of 9 cases

目的：总结采用同种异体脱细胞生物组织补片整复、修补先天性腹裂的治疗经验。方法回顾性的分析自2010年以来采用同种异体脱细胞生物组织补片修补的新生儿先天性腹裂9例患儿的临床资料。患儿入院后尽快送入手术室，以温生理盐水及温碘伏仔细冲洗并还纳脱出的腹腔内容物后，将生物组织补片与除皮肤外的腹壁创口边缘全层间断缝合。术后送SICU监护。3例患儿未行呼吸机支持治疗，6例患儿分别行呼吸机支持治疗1～2d。结果9例患儿术后恢复顺利，切口愈合好，无红肿渗液，痊愈出院。随访6月～3年，其中7例腹壁缺损已完全愈合，2例留有小型腹壁疝，待二次手术修补，患儿营养发育与同龄儿无明显差别。结论腹裂手术的原则是回纳疝出脏器，关闭腹壁筋膜及皮肤。但由于腹壁缺损大，需要采取分期手术或延迟手术。生物组织补片其细胞毒性小，生物相容性好，无明显致敏性及排斥反应，修补腹裂后，能有效的减轻腹腔压力，可以一期完成手术，适用于先天性腹裂的治疗。

Objetive To summarize the treatment experience of using allogeneic acellular biological tis-sue patch restoration to repair gastroschisis. Methods A retrospective analysis 9 patients clinical datum since 201 0 using allogeneic acellular biological tissue patch to repair congenital gastroschisis.Children admitted to hospital as soon as possible into the operating room,with warm saline and carefully rinse and warm iodine also satisfied after prolapse of abdominal contents,the biological tissue patch in addition to the outer skin of the ab-dominal wall and the edge of full-thickness wound was sutured.SICU care after delivery.3 patients did not un-dergo ventilator support treatment,six cases were performed in children with respiratory support treatment of 1 to 2 days. Results 9 patients recovered well after surgery,wound healing,and no swelling and effusion,dis-charged.Followed up for 6 months to 3 years,including seven cases of abdominal wall defects have been com-pletely healed,two cases of small left abdominal wall hernia,to be secondary surgical repair,development and nutrition in children with no significant difference in age children. Conclusion the principle of gastroschisis surgery herniated organs back satisfied,close the abdominal wall fascia and skin.However,due to a large ab-dominal wall defects,need to take surgical staging or delayed surgery.Biological tissue patch their cellular tox-icity,biocompatibility,and no obvious sensitization and rejection,repair gastroschisis,can effectively reduce abdominal pressure,can be a complete surgery for the treatment of gastroschisis.