[1]顾松,吴晔明,宋波,等.一次性无菌腹裂治疗袋应用规范[J].临床小儿外科杂志,2020,19(04):297-300.[doi:10.3969/j.issn.1671-6353.2020.04.003]
　Gu Song,Wu Yeming,Song Bo,et al.Application guideline of disposable aseptic gastroschisis treatment bag[J].Journal of Clinical Pediatric Surgery,2020,19(04):297-300.[doi:10.3969/j.issn.1671-6353.2020.04.003]
点击复制

一次性无菌腹裂治疗袋应用规范

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第19卷 期数: 2020年04期 页码: 297-300 栏目: 标准与规范 出版日期: 2020-04-28
Title:
Application guideline of disposable aseptic gastroschisis treatment bag
作者:
顾松1;  吴晔明2; 4;  宋波3;  汪健4
1. 上海交通大学医学院附属上海儿童医学中心(上海市, 200127);
2. 上海交通大学医学院附属新华医院(上海市, 200092);
3. 上海淞行实业有限公司(上海市, 200072);
4. 苏州大学附属儿童医院(江苏省苏州市, 215000)
Author(s):
Gu Song1;  Wu Yeming2; 4;  Song Bo3;  Wang Jian4
1. Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200127;
2. Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200127;
3. Shanghai Songhang Industrial Co., Ltd., Shanghai 200072;
4. Children’s Hospital of Soochow University, Suzhou 215000, China
关键词:
腹裂; 生物相容性材料; 治疗应用; 规范; 婴儿; 新生
Keywords:
Gastroschisis; Therapeutic Uses; Benchmarking; Infant;  Newborn
分类号:
R726;R656.3+3
DOI:
10.3969/j.issn.1671-6353.2020.04.003
摘要:
新生儿腹裂是一种危及生命的严重先天性腹壁畸形，约50%的腹裂患儿需分期修补腹壁缺损。随着国际通用Silo袋的广泛应用，在欧美发达国家腹裂患儿的病死率已降至10%以下。在我国，严重腹裂患儿因缺乏规范有效的治疗模式，部分患儿没有得到及时治疗，导致肠管水肿不断加重；由于缺乏正规的腹裂治疗袋产品，通常采用各种不规范的临时材料应急，导致术后并发症多，早期病死率较高。吴晔明等通过改良国外的Silo技术，开发出具有自主知识产权的腹裂治疗袋，在床边非麻醉下免缝分期治疗新生儿严重腹裂，提出在腹裂治疗袋壁贴敷氧饱和度探头，同时行膀胱测压，实时监测腹裂袋中肠管血供，可及时发现和有效避免腹裂袋中肠管缺血坏死，提高该技术的安全性和可靠性，降低严重腹裂患儿的病死率。该技术在上海交通大学医学院附属新华医院和上海儿童医学中心收治的严重腹裂患儿中已成功应用且趋于成熟，在全国20多家三甲医院得到推广，产生了较好的社会效益。
Abstract:
Neonatal gastroschisis is a severe life-threatening congenital abdominal wall deformity and around 50% of neonatal patients require staged repairing.With the widespread use of Silo bags,the mortality rate has dropped below 10% in developed countries.In China,due to a lack of effective and standardized treatment modes,some newborns with severe gastroschisis (NSG) have not been timely treated.No standard Silo bag product for NSG results in more complications and higher early mortality.There is a large gap with European developed countries and the United States.The team led by Professor Wu Yeming has developed a gastroschisis treatment bag (GTB) for NSG with independent intellectual property rights by improving Silo technology abroad.At the same time,a new technique of treating NSG by stages without suturing under non-anesthesia is developed clinically.An oxygen saturation probe is mounted on the wall of GTB along with bladder manometry and real-time monitoring of intestinal blood supply.Capable of effectively preventing intestinal ischemic necrosis in GTB,it greatly improves the safety and reliability of this technology and significantly reduces the mortality of NSG.The technology has been successfully applied extensively at over 20 domestic class 3A hospitals.Great social benefits have been harvested.

参考文献/References:

1 吴晔明.我国新生儿腹裂的诊治现状及思考[J].临床小儿外科杂志,2007,6(6):1-2.DOI:10.3969/j.issn.1671-6353.2007.06.001. Wu YM.Current situation and thinking of diagnosis and treatment of neonatal gastroschisis in China[J].J Clin Ped Sur,2007,6(6):1-2.DOI:10.3969/j.issn.1671-6353.2007.06.001.
2 陈盛,吴晔明,洪莉,等.先天性腹裂治疗方式20年系统评价[J].临床小儿外科杂志,2008,7(4):11-15.DOI:10.3969/j.issn.1671-6353.2008.04.004. Chen S,Wu YM,Hong L,et al.Systematic review of treatment method of gastroschisis in 1998-2007[J].J Clin Ped Sur,2008,7(4):11-15.DOI:10.3969/j.issn.1671-6353.2008.04.004.
3 Wu Y,Vogel AM,Sailhamer EA,et al,Primary insertion of a silastic spring-loaded silo for gastroschisis[J].Am Surg,2003,69(12):1083-1086.DOI:10.1046/j.1600-6135.2003.00270.x.
4 Crane E,Morris JK.Paternal age and birth defects:how strong is the association[J].Hum Reprod,2007,22(8):2349-2350.DOI:10.1093/humrep/dem134.
5 Briganti V,Luvero D,Gulia C,et al.A novel approach in the treatment of neonatal gastroschisis:a review of the literature and a single-center experience[J].J Matern Fetal Neonatal Med,2018,31(9):1234-1240.DOI:10.1080/14767058.2017.1311859.
6 周光萱,朱军,代礼,等.1996至2000年全国先天性腹裂畸形监测资料分析[J].中华预防医学杂志,2005,39(4):257-259.DOI:10.3760/j:issn:0253-9624.2005.04.009. Zhou GX,Zhu J,Dai L,et al.Analysis of the monitoring data of congenital gastroschisis deformity in China from [1996] to 2000[J].Chin J Prev Med,2005,39(4):257-259.DOI:10.3760/j:issn:0253-9624.2005.04.009.
7 吴晔明,洪莉,王俊,等.应用免缝腹裂袋分期处理严重新生儿腹裂[J].中华外科杂志,2007,45(21):1461-1462.DOI:10.3760/j.issn:0529-5815.2007.21.009. Wu YM,Hong L,Wang J,et al.Application of peritoneal fissure bag free in stages to treat severe neonatal gastroschisis[J].Chin J Surg,2007,45(21):1461-1462.DOI:10.3760/j.issn:0529-5815.2007.21.009.
8 陈盛,吴晔明,洪莉,等.先天性腹裂的临床回顾性研究[J].中华小儿外科杂志,2008,29(5):260-263.DOI:10.3760/cma.j.issn.0253-3006.2008.05.002. Chen S,Wu YM,Hong L,et al.Retrospective study of congenital gastroschisis[J].Chin J Pediatr Surg,2008,29(5):260-263.DOI:10.3760/cma.j.issn.0253-3006.2008.05.002.
9 吴晔明,洪莉,严志龙,等.腹裂患儿Silo袋内肠管血供监测的方法探讨[J].临床小儿外科杂志,2009,8(5):22-23,27.DOI:10.3969/j.issn.1671-6353.2009.05.008. Wu YM,Hong L,Yan ZL,et al.Monitoring the blood supply of the intestine in the Silo pouch for infants with gastroschisis using pulse oxymeter as a new method[J].J Clin Ped Sur,2009,8(5):22-23,27.DOI:10.3969/j.issn.1671-6353.2009.05.008.
10 Li H,Wu YM,Yan ZL,et al.Modified silo technique-an ea-sy and effective method to improve the survival rate of neonates with gastroschisis in Shanghai[J].Eur J Obstet Gynecol Reprod Biol,2010,148(1):31-34.DOI:10.1016/j.ejogrb.2009.09.022.
11 Du L,Pan WH,Cai W,et al.Delivery room surgery:an applicable therapeutic strategy for gastroschisis in developing countries[J].World J Pediatr,2014,10(1):69-73.DOI:10.1007/s12519-014-0455-3.
12 严文波,潘伟华,武志祥,等.新生儿先天性腹裂外科处理后转归[J].临床外科杂志,2016,24(11):879-881.DOI:10.3969/j.issn.1005-6483.2016.11.027. Yan WB,Pan WH,Wu ZX,et al.Clinical outcome of neonates with congenital gastroschisis after surgical treatments[J].J Clin Sur,2016,24(11):879-881.DOI:10.3969/j.issn.1005-6483.2016.11.027.
13 黄晶晶,王红,李新宁.一期缝合与应用免缝腹裂袋"silo"分期修复先天性腹裂的疗效对比[J].广西医学,2015,37(1):59-61.DOI:10.11675/j.issn.0253-4304.2015.01.19. Huang JJ,Wang H,Li XN.A comparative analysis of congenital gastroschisis treated with primary suture repair versus silo staged repair[J].Guangxi Medical Journal,2015,37(1):59-61.DOI:10.11675/j.issn.0253-4304.2015.01.19.
14 胡耀宗,徐冰,蔡宝,等."产房外科"模式治疗新生儿腹裂五例[J].中华围产医学杂志,2017,20(1):45-47.DOI:10.3760/cma.j.issn.1007-9408.2017.01.010. Hu YZ,Xu B,Cai B,et al.Five cases of neonatal gastroschisis treated by "Obstetric Surgery" Model[J].Chin J Perinat Med,2017,20(1):45-47.DOI:10.3760/cma.j.issn.1007-9408.2017.01.010.
15 张志涛,周胜兰,刘彩霞,等.胎儿腹裂的产前诊断与产时手术[J].中华围产医学杂志,2014,17(2):128-130.DOI:10.3760/cma.j.issn.1007-9408.2014.02.013. Zhang ZT,Zhou SL,Liu CX,et al.Prenatal diagnosis and operation of fetal abdominal fissure[J].Chin J Perinat Med,2014,17(2):128-130.DOI:10.3760/cma.j.issn.1007-9408.2014.02.013.

相似文献/References:

[1]邱永升,贾英萍,梁郑,等.先天性脐膨出、腹裂患儿的围术期管理[J].临床小儿外科杂志,2007,6(02):23.
[2]王鹏,黄寿奖,秦琪,等.一期手术治疗严重腹壁缺损及手术后腹腔压力变化探讨[J].临床小儿外科杂志,2018,17(02):122.
　Wang Peng,Huang Shoujiang,Qin Qi,et al.The application of One-stage operation in treating severe abdominal wall defect and postoperative abdominal pressure variation features.[J].Journal of Clinical Pediatric Surgery,2018,17(04):122.

备注/Memo

收稿日期:2019-02-11。
通讯作者:吴晔明,Email:wuymsh@163.com

更新日期/Last Update: 1900-01-01