Huang Zijun,Xu Suting,Li Sha,et al.Efficacy of treating giant omphalocele by procedural dressing and delayed closure[J].Journal of Clinical Pediatric Surgery,2020,19(04):301-305.[doi:10.3969/j.issn.1671-6353.2020.04.004]
程序化包扎法、延期手术治疗巨型脐膨出的疗效分析
- Title:
- Efficacy of treating giant omphalocele by procedural dressing and delayed closure
- Keywords:
- Hernia; Umbilical/DI; Hernia; Umbilical/SU; Reconstructive Surgical Procedures; Treatment Outcome
- 分类号:
- R726.1;R657.7;R628
- 摘要:
- 目的 探讨新生儿期采用程序化包扎法、延期手术治疗巨型脐膨出的安全性和有效性。方法 回顾性分析2016年12月至2018年7月广州市妇女儿童医疗中心收治的采用程序化包扎法，延期手术治疗的巨型脐膨出患儿临床资料。结果 7例患儿出生时囊膜均无破裂，包扎期待治疗期间无囊膜感染、破裂、肠梗阻、中断包扎等并发症发生，未再次入院；囊膜达到干痂期中位数时间为5（4~5）d，囊膜完成上皮化中位数时间为65（57~68）d，家长培训时间中位数6（3~12）d，住院时间中位数21（19~29）d；7例患儿均存活，其中6例行腹壁缺损修补手术，2例术后分别需要5 h和17 h呼吸机支持，住院时间中位数9.5（7.25~10.25）d，术后均未出现伤口预后不良、切口疝等手术并发症。1例正在等待延期修补术。结论 程序化包扎法、延期手术治疗巨型脐膨出的方法是安全有效的，其对巨型脐膨出远期预后的影响需进一步随访研究。
- Abstract:
- Objective To explore the safety and efficacy of procedural dressing and delayed operation for neonatal giant omphaloceles.Methods A retrospective study was performed for clinical data of giant omphaloceles treated by procedural dressing and delayed closure from December 2016 to July 2018.Results A total of 7 cases were recruited.There was no rupture of capsule membrane during birth.There were no such complications as capsule infection,rupture,intestinal obstruction,bandaging difficulty and re-admission during treatment.The capsule membrane for dry scar period needed 5(IQR:4~5)d days.The capsule membrane for completing epithelialization needed 65(57-68) days.It took 6(3-12) days for parents to learn dressing.The median length of hospital stay was 21(19-29) days.All seven cases survived.6 cases underwent abdominal wall defect repairing.And 2/7 cases required ventilator supports for 5 and 17 hours respectively.The median length of hospital stay was 9.5(7.25-10.25) days.Neither poor wound healing nor incisional hernia occurred postoperatively.One case still awaited delayed closure.Conclusion Procedural dressing and delayed closure are safe and effective for treating giant omphaloceles.However,long-term prognosis needs more follow-up studies.
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备注/Memo
收稿日期:2019-11-27。
通讯作者:钟微,Email:zhongwei@gwcmc.org