儿童绞窄性肠梗阻的诊断和治疗

The diagnosis and treatment of strangulating small bowel obstruction in children

目的探讨儿童绞窄性肠梗阻的诊断和治疗。方法回顾性分析2013年8月至2014年7月我院收治的5例绞窄性肠梗阻患儿的临床资料,总结早期诊断和手术治疗的经验。结果 5例均急诊手术证实为绞窄性肠梗阻,其中肠系膜裂孔疝并空肠坏死2例,美克尔憩室索带压迫并回肠坏死1例,回肠扭转并坏死2例。所有患儿均一期行坏死肠切除肠吻合术,无死亡病例,术后无短肠综合征发生;无休克复苏后脑损伤发生。随访2年所有患儿身高、体重等生长指标发育良好,无饮食障碍、排便障碍发生。结论详细的体格检查,及时的影像学检查以及常规的腹腔穿刺检查是明确绞窄性肠梗阻的充分依据;正确及时手术治疗是明确病因、祛除病灶的根本途径。

Objective To investigate the diagnosis and treatment of strangulating small bowel obstruction in children .Meth-ods The clinical data of 5 children with strangulating small bowel obstruction admitted between August 2013 and July 2014 at our de-partment were retrospectively analyzed to summarize the experience in its early diagnosis and surgical treatment .Results The all pa-tients were confirmed to suffer the disease by emergency surgery .There were 2 cases with mesenteric hiatal hernia and jejunal necrosis , 1 case with Meckel＇s diverticulum cord compression and ileal necrosis ,and 2 cases with volvulus of ileum and necrosis .The intestinal anastomosis was performed in all patients .There was no death ,no short bowel syndrome after operation ,and no brain injury after shock resuscitation.The patients were followed up for 2 years,and all of them recovered well .There were no postoperative complications such as digestive disorders and defecation disorders .Their growth indexes such as height and weight were well developed .Conclusion The detailed physical examination ,timely image examination and routine abdominal paracentesis are the basis for diagnosis of strangulating small bowel obstruction .The correct and timely surgical treatment is the basic way to clear the cause of the disease and eliminate the le -sions.