儿童肠旋转不良的诊断与治疗

    目的  儿童肠旋转不良在临床上诊断困难，易漏诊而延误治疗，本文拟通过回顾性分析总结诊断与治疗本病的要点。

　　方法  对18例4～15岁的先天性肠旋转不良患儿进行回顾分析。

　　结果  发现儿童肠旋转不良其临床表现有症状较轻且不典型的特点，具体表现为：（1）复发性呕吐，且可以是非胆汁性呕吐；(2)间歇性腹痛；(3)便秘或顽固性腹泻。

　　结论  出现反复性呕吐（包括非胆汁性呕吐）、腹痛、腹泻久治不愈者，应常规行钡灌肠检查，如证实为肠旋转不良，Ladd s 手术是安全可靠的治疗方法。

　　【关键词】  肠旋转不良；儿童；诊断；治疗

　　 Diagnosis and treatment of intestinal malrotation in children:18 cases analysis

　　ZHANG Lu-dong，ZHANG Wen-xia，DING Rong.Shenzhen Maternal and Children Healthcare Hospital,Shenzhen 518028，China

　　【Abstract】 

    Objective  Clinical diagnoses on intestinal malrotation in children is very difficult, it is easy to delay treatment because of miss diagnosis.This article is to discuss methods to improve accuracy of diagnosis through retrospective research.

　　Methods  We retrospectively analyzed 18 cases of congenital intestinal malrotation in 4 to 15 years old during 1996 to 2002.

　　Results  We found that the disease in this period shows gentler and less typical clinical appearance than in neonatal cases,includes:1) repetitive vomit,possibly non-bile-stained vomit; 2) intermittent bellyache; 3) constipation or durative diarrhea.

　　 Conclusion  Analysis suggests that routine barium clysis exam in cases with symptoms above should promote diagnoses accuracy of the disease.Once diagnosed,Ladd s operation should be introduced as safe and reliable therapy to correct the malformation.

　　【Key words

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