先天性肠旋转不良诊断和治疗的探讨

目的探讨先天性肠旋转不良的临床特点,诊断和外科治疗方法。方法对我院1979年～2006年收治的68例先天性肠旋转不良患儿进行回顾性分析。结果先天性肠旋转不良的临床表现随年龄而异,大多数发生在新生儿期,且以男性为多。主要临床表现为肠梗阻,本组全部采用Ladd抯手术附带阑尾切除术,合并其它畸形12例,占17.6%.治愈60例（88.2%）,死亡8例（11.8%）。结论先天性肠旋转不良的临床表现缺乏特异性,主要依据病史和X线影像学检查,漏诊和误诊的主要原因是认识不足,早期准确诊断和手术治疗将提高治愈率。

Study on the diagnosis and treatment of congenital intestinal malrotation.

Objective To investigate the clinical characteristics, diagnostic methods and surgical treatment of congenital intestinal malrotation,promote the ability of diagnosis and treatment. Methods To retrospective study of congenital intestinal malrotation admitted in 68 cases treated from 1979 to 2006 was reviewed. Results 53 cases were boys,and 15 were girls,their age rang was 8 days to 7 years.Bilious vomiting was the characteristic clinical situation in neonatal period.Beyond the neonatal period,recurrent vomiting and chronic intermittent abdominal pain was the main symptom. All the cases were treated with Ladd 抯operation method.12 cases have other malformation, 17.6%.Of 68 cases,50 cases were cured after operation,and the curative rate reached 88.2%,8 case died （11.8%）. Conclusions The clinical situation of congenital intestinal malrotation is lack of specificity.The deficiency of knowledge and paying less attention to congenital intestinal malrotation is the main cause that leads to misdiagnosis and missed diagnosis.Early diagnosis and operation treatment is the key to improve the curative effect.