30例新生儿先天性胃壁肌层缺损致胃穿孔的诊疗分析

Observation on 30 Cases of Gastric Perforation Caused by Congenital Gastric Wall Muscular Layer Defect in Neo⁃nates and Their Diagnosis and Treatment

目的:探讨新生儿先天性胃壁肌层缺损致胃穿孔的临床特点及诊疗措施,为新生儿先天性胃壁肌层缺损致胃穿孔的临床诊治提供参考依据。方法:选取2021年4月—2023年4月贵阳市妇幼保健院收治的30例新生儿先天性胃壁肌层缺损致胃穿孔患儿为研究对象,分析其临床资料。结果:30例患儿均接受手术治疗,治愈率为63.33%(19/30)。术后病理检查均提示先天性胃壁肌层缺损。放弃治疗11例。结论:对于新生儿先天性胃壁肌层缺损致胃穿孔,需根据患儿临床表现、病史、体征等明确诊断,对于诊断确切并符合手术指征的患儿,应积极进行手术探查,尽早发现病灶,将修补胃壁切除,积极矫正消化道畸形,同时进行抗休克、抗感染治疗,可降低病死率,提高手术疗效,促进患儿早日康复。

Objective:To investigate the clinical characteristics and diagnostic and therapeutic measures of gastric perforation caused by congenital gastric wall muscular layer defect in neonates,and to provide reference basis for the clinical diagnosis and treatment of gastric perforation caused by congenital gastric wall muscular layer defect in neonates.Methods:30 cases of neonatal congenital gastric wall muscular layer defect causing gastric perforation admitted to Guiyang Maternal and Child Health Hospital from April 2021 to April 2023 were selected as the observation subjects,and their clinical data were analyzed.Results:All 30 children underwent surgical operation,and the cure rate was 63.33%(19/30).Postoperative pathologic examinations of all the patients suggested congenital gastric wall muscular layer defect.Further treatment was abandoned in 11 cases.Conclusion:For congenital gastric wall muscular layer defect causing gastric perforation in neonates,it is necessary to make a clear diagnosis based on the children's clinical manifestations,medical history,signs and symptoms,etc.For the children whose diagnosis is exact and meets the indications for surgery,surgical exploration should be carried out for the early detection of the lesion so that defected gastric wall can be removed;and anti-shock and anti-infection treatment could be carried out at the same time,which can reduce the case-fatality rate,increase the effectiveness of the surgery,and promote the children's early recovery.