新生儿肠旋转不良的诊治分析

Clinical study on the newborns of congenital malrotation of intestine in neonatal period

目的 分析新生儿期先天性肠旋转不良的临床特点及诊治方法。 方法 回顾分析 1996～ 2 0 0 3年 12例新生儿期先天性肠旋转不良 ,男 10例 ,女 2例 ,就诊时出生 7～ 75d ,平均 45d ,术前均经泛影葡胺口服及灌肠造影确诊后行Ladd术 ,附加阑尾切除术。 结果 本组 1例术后并发粘连性肠梗阻二次手术行粘连松解术 ,其余 11例无并发症 ,全部治愈出院。 结论 本病的发病机制是由于并发急性肠扭转所致高位十二指肠的梗阻。主要临床特点是反复间断性胆汁性呕吐 ,口服和灌肠的消化道造影是诊断本病的最可靠依据。Ladd式手术是本病手术治疗的最佳选择 ,且效果满意。

Objective To analyse the manifestations, diagnostic and treatment of infant with congenital malrotation of intestine in neonatal period. Methods Twelve cases, 10 males and 2 females, of congenital malrotation of intestine in neonatal period from 1996～2003 were analysed retrospectively. All patients were undergone Ladd procedure and appendetomy after diagnosed by oral or enema Urografin radiography 7～75days (median 45 days) after birth.Results Eleven patients healed without any complication,and one was undergone intestinal adhesiolysis due to adhesive ileus. Conclusion The higher duodenal obstruction due to acute volvulus often occur in patients with congenital malrotation of intestinael in neonatal period. Repeatedly interrupted cholemesis the main manifestation, and diagnosis mainly depends on oral or enema digestive tract radiograply. Laddis effectiue for treatment of the illness.