新生儿胎粪性肠梗阻21例诊治分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第13卷期数: 2014年02期页码: 125-128 栏目: 论著出版日期: 2014-04-28

作者:: 冯奇王斌陈子民; 深圳市儿童医院普外二病区

关键词:: ; 胎粪; 肠梗阻; 婴儿; 新生

文献标志码:: A

摘要:: 目的探讨新生儿胎粪性肠梗阻的诊疗经验，提高新生儿外科医师对该病的认识。方法回顾性分析本院2002年至2012年收治的21例胎粪性肠梗阻患儿临床资料。结果21例中，17例为单纯型，4例为复杂型；20例行稀释泛影葡胺灌肠造影，依靠该检查明确诊断5例，其中3例经非手术治疗痊愈。18例手术患儿中，14例单纯型行急诊手术治疗，其中10例采用肠管切开灌洗+肠造瘘术（7例采用回肠双腔造瘘术，3例采用回肠BishopKoop造瘘术），4例采用阑尾切除、肠内灌洗术（3例留置阑尾造瘘管）。4例复杂型均行急诊手术，2例采用回肠双腔造瘘术，2例术中放弃治疗。18例手术患儿中，16例术后恢复良好,10例造瘘患儿术后7~16周行造瘘还纳术。结论稀释泛影葡胺灌肠造影既能有效协助诊断，又能使少部分患儿治愈；BishopKoop造瘘术为首选术式；胎粪较易排出的患儿可选用阑尾切除、肠内灌洗术。

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