[1]潘登,王献良,邵雷朋..新生儿坏死性小肠结肠炎经回肠造瘘术后远端肠闭锁7例[J].临床小儿外科杂志,2016,15(05):513-515.
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新生儿坏死性小肠结肠炎经回肠造瘘术后远端肠闭锁7例

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第15卷 期数: 2016年05期 页码: 513-515 栏目: 经验交流 出版日期: 2016-10-28
作者:
?潘登; 王献良; 邵雷朋.
?郑州市儿童医院新生儿外科
关键词:
小肠结肠炎; 坏死性;  回肠造口术;  肠闭锁;  婴儿; 新生
文献标志码:
A
摘要:
?目的探讨新生儿坏死性小肠结肠炎(NEC)行回肠造瘘术后，造瘘远端肠闭锁的临床特点和诊治经验。方法对本院自2010年7月至2015年2月收治的7例NEC行回肠造瘘术后，远端继发肠闭锁的临床资料进行回顾性分析。7例均无明显临床表现，结肠造影提示结肠梗阻。术中发现闭锁部位：2例为两处闭锁，1例为回肠末端、结肠肝区闭锁，1例为结肠脾区、乙状结肠闭锁；其余5例为单处闭锁，3例为乙状结肠闭锁，1例为降结肠闭锁，1例为横结肠闭锁。结果7例手术后均痊愈出院，7例随访过程中，1例间断出现肉眼或镜下血便，经结肠造影发现有结肠狭窄，其余无明显排便异常表现，疗效满意。结论临床上NEC保守治疗后反复喂养不耐受、腹胀，应警惕肠狭窄；行回肠造瘘术后，远端肠管发生继发性闭锁应予以重视，炎症反应可能是其主要原因之一。一期造瘘术后应定期对远端肠管给予盐水灌肠, 以避免肠管炎性闭锁发生。

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