儿童幽门前瓣膜症7例临床分析

Clinical analysis of 7 children with Preyloric membrane

目的探讨幽门前瓣膜症(PM)的临床特点和诊治方式,提高幽门前瓣膜症的诊治水平。方法回顾性分析郑州大学第一附属医院小儿外科2012-01-2022-09诊断为PM患儿的临床资料。结果共选入7例患儿,平均初次出现症状年龄为9.7个月,病程1个月~8 a。行非手术治疗后5例行手术治疗,其中4例行开腹下瓣膜切除及幽门成形术,1例行内镜下幽门切除术。随访期间7例患儿均未再出现间断呕吐症状。结论PM极易误诊、漏诊,消化道造影、腹部超声及胃镜的联合应用对PM有重要诊断价值。对婴幼儿反复非胆汁性呕吐,经腹部超声发现幽门无肥厚者可考虑PM。内镜不仅能帮助诊断,也可直接行手术治疗,可极大减少手术损伤。

Objective To explore the clinical features,diagnosis and treatment of anterior pyloric valve disease(PM),and to improve the diagnosis and treatment of anterior pyloric valve disease.Methods The clinical data of children with PM diagnosed in the Department of Pediatric surgery of the First Affiliated Hospital of Zhengzhou University from 2012-01 to 2022-09 were analyzed retrospectively.Results A total of 7 children were selected.the average age of onset of symptoms was 9.7 months and the course of disease ranged from 1 month to 8 years.After non-operative treatment,5 cases were treated by operation,including 4 cases of open subabdominal valvular resection and pyloroplasty and 1 case of endoscopic pyloric resection.During the follow-up period,no intermittent vomiting occurred in all the 7 children.Conclusion PM is easy to be misdiagnosed and missed.The combined application of gastrointestinal radiography,abdominal ultrasound and gastroscopy has important diagnostic value for PM.For infants with recurrent non-biliary vomiting,PM can be considered if no pyloric hypertrophy is found by transabdominal ultrasound.Endoscopy can not only help diagnosis,but also can be treated directly by surgery,which can greatly reduce surgical injury.