新生儿十二指肠梗阻诊治方法探讨

目的 探讨新生儿十二指肠梗阻的诊治方法与病理特点。方法 总结近10年来56例新生儿十二指肠梗阻的临床资料,对术前诊断、病理分型及治疗方法进行回顾性分析。结果 56例患儿术前均行X线腹部平片检查,51例行上消化道造影检查,28例行钡灌肠检查．22例行超声检查。56例患儿均在全麻下实施手术治疗,手术证实先天性肠旋转不良28例(50％),十二指肠膜状狭窄、闭锁18例(32．1％),环状胰腺8例(14．3％),先天性异常索带2例(3．6％)。治愈52例,死亡4例(7．14％)。结论 术前X线检查是诊断新生儿十二指肠梗阻的有效方法,先天性肠旋转不良为首发病理类型,一旦确诊宜积极早期手术。

The diagnosis and treatment of neonatal duodenal obstruction

Objective To explore the diagnosis and treatment of neonatal duodenal obstruction and its pathological characteristics.Methods The clinical data of 56 cases of neonatal duodenal obstruction treated in the past ten years were summarized in this literature and the preoperative diagnosis,pathological typing and treatments were retrospectively analyzed as well.Results All the patients underwent X-ray plain film examination,In addition,51 cases of them received contrast examination of upper digestive tract,28 cases underwent barium enema examination and 22 cases got ultrasonic examination. The operations confirmed that there existed 28 cases (50%) of congenital malrotation of intestine,18 cases(32.1%) of membranous atresia and stenosis of duodenum,8 cases(14.3%) of annular pancreas and 2 cases(3.6%) of congenital abnormal cords. All of them received operations under general anesthesia,52 cases were cured,only 4 cases(7.14%) died after operation.Conclusion Preoperative X-ray examination can be used to diagnose neonatal duodenal obstruction effectively. Congenital malrotation of intestine has proven to be the type of first attack,therefore,early positive operations are advocated here once the disease has been confirmed.