非麻醉下床边应用免缝Silo袋处理新生儿腹裂

目的 介绍非麻醉状态下于床边应用免缝Silo袋分期处理无法Ⅰ期关闭的新生儿腹裂。方法 2004年3月和7月．收治2例新生儿腹裂，分别出生后2h和4h，1例肠管污染严重，另1例合并有肠旋转不良和胎粪性肠梗阻，2例均在清醒状态下于NICU床边应用免缝Silo袋Ⅰ期处理无法回纳腹腔的肠管，2例分别于第6d和第7d在肠管完全回纳腹腔后至手术室全麻下行腹壁关闭脐部成形术，其中例2同期行Ladd’s术和肠内胎粪清除术。结果 2例患儿术后恢复好，脐部Ⅰ期愈合，分别随访5个月和2个月，生长发育好。结论非麻醉状态下床边应用免缝Silo袋分期处理无法Ⅰ期回纳的新生儿腹裂是一简便安全的方法，并可推广至产房早期处理腹裂患儿，将有效减少患儿肠管的继发性水肿和炎症，提高生存率。

Application a silastic spring-loaded silo for infants with gastroschisis without anaesthesia NICU

Objective To introduce a new technique which using a silastic spring-loaded silo(SLS) for infants with gastroschisis with no anaesthesia in NICU.Methods Between March and July,2004,two infants with gastroschisis were treated successfully in Shanghai Children`s Medical Center using silastic SLS under non-anaesthesia bedside in NICU.One baby was only 4 hours after birth at admission,another had associated intestinal malrotation and meconium ileus was 2 hours after birth.Both of them underwent SLS closure at bedside in NICU.When the bowel was completely reduced,a second-stage closure was performed in the operating-room under general anaesthesia.One of two underwent the Ladd`s procedure and cleaning of meconium ileus.Results Two infants recovered well after operation and were follow up for five months and two months repectively.They are all alive and well.Conclusions Non-anaesthesia bedside SLS for the infants with gastroschisis is a simple and save method.It will reduce the chance infection and increase the survival rate,if applied in the delivery-room.