先天性肠闭锁、肠狭窄20年治疗回顾(附66例报告)

目的探讨各类型肠闭锁、肠狭窄的适用手术方式,并对疗效提高的原因进行分析.方法总结我院近20年经手术治疗的66例先天性肠闭锁、肠狭窄患者的临床资料.结果总治愈率为77.27%,其中前10年治愈率为67.44%,后10年治愈率为95.65%,疗效有极明显提高.结论①十二指肠及空肠近端膜式闭锁或狭窄应首选隔膜切除、肠管纵切横缝术;②十二指肠闭锁(除膜式闭锁)及环状胰腺应首选十二指肠-十二指肠菱形吻合术;③小肠、结肠闭锁(除膜式闭锁)应优先选择近端扩张肠管切除、端背吻合术.TPN的广泛应用、围手术期的综合管理、合理手术方式的选择及手术材料的改进对疗效的提高起到了明显作用.

Congenital intestinal atresia and stenosis:a review of sixty-six cases

Objective To compare the difference between surgical procedure and analyze the cause of treatment improvement.Methods Sixty six cases of intestinal atresia and stenosis in the past 20 years in our institute were reviewed.Results The total cure rate was 77.27%.The cure rate in last 10 years was greatly improved comparing with previous decade (95.65% vs 67.44%).Conclusions The surgical procedure should be chosen carefully according pathological pattern.Membrane atresia and stenosis in duodenum and proximal jejunal should have the membrane resected and then anastomosed longitudinally.Diamond duodenoduodenostomy should be performed in duodenal atresia.In ileal and colonic atresia,the dilated loop should be resected and end to back anastomosed.Wide usage of TPN management,intensive perioperative care,appropriate surgical procedure and new surgical materials have greatly improved the outcome.