先天性消化道畸形142例临床特征分析

目的 探讨先天性消化道畸形患儿的临床特征,以利于早期诊断、选择恰当手术时机、提高存活率。方法 选择2011年2月至2013年6月在湖南省儿童医院新生儿外科住院并确诊为先天性消化道畸形的患儿,分析其临床资料,总结发病特征、治疗过程及转归。结果 研究期间共收治142例先天性消化道畸形患儿,畸形种类以肛门直肠畸形、先天性巨结肠症、先天性肥厚性幽门狭窄比例最高,分别占27.5%、19.0%、12.7%。生后1天内发病比例最高,生后5天内发病占69.7%。呕吐、腹胀、胎便异常为先天性消化道畸形的主要临床表现,分别占主诉的55.6%、34.5%、18.3%。以呕吐为主要表现的病例就诊要普遍早于腹胀、排便异常为主诉的病例。呕吐后引起的电解质紊乱占26.1%,营养不良占17.8%。结论 在我院统计的142例先天性消化道畸形患儿中,发病种类以肛门直肠畸形、先天性巨结肠症、先天性肥厚性幽门狭窄位居前三位。发病时间在生后1天内最多,呕吐为最主要的临床表现,呕吐后引起的电解质紊乱和营养不良为主要并发症。

The study on clinical characteristics of congenital digestive tract malformation

Objective malformation and provide some diagnosed as having congenital The study describes the characteristics of the congenital digestive tract reference for diagnosis and treatment. Methods Children who were digestive tract malformation in the neonatal surgical ward of Hunan Children＇s Hospital from February 2011-June 2013, were included in this study. The clinical features of the cohort （n = 142） were summarized. Results The three leading causes of congenital digestive tract malformation were anorectal malformation, congenital Hirschsprung disease and congenital hypertrophic pyloric stenosis with respective frequency of 27.5%, 19. 0% and 12. 7% . Vomiting, abdominal distension and delayed passing of meconium were the major clinical manifestations with respective frequency of 55.6%, 34. 5% and 18.3%. Associated complications due to vomiting were： electrolyte imbalance （26. 1% ） and weight loss （ 17.8% ）. Conclusions Anorectal malformation, congenital hirsehsprung disease and congenital hypertrophic pyloric stenosis were ranked respectively first, second and third. The majority of clinical symptoms ap clinical manifestation, followed by electrolyte survival rate is diagnosis as early as possible. peared on the first day after birth. Vomiting was the major imbalance and malnutrition. The key to improve the survival rate is diagnosis as early as possible.