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新生儿横结肠双腔造口术并发症的防治 附37例报告 |
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吴江 吴绍文 陈明 黄庆荣 陈殷琴
【摘 要】 目的 探讨新生儿横结肠双腔造口术并发症的原因和防治措施。方 法 对37例新生儿横结肠双腔造口术进行随访。结果 除2例死亡外，造口 周围皮炎31例，造口粘膜炎性息肉19例，造口狭窄4例，造口肠脱出4例，粘连性肠梗阻2例 ，误将乙状结肠作横结肠造口2例。结论 并发症常由于术中处理不当或术后护 理不当而引起，并提出了防治措施。
【关键词】 新生儿 横结肠双腔造口术 并发症
Prevention and treatment of complications due to loop transversostomy in neonates:a report of 37 cases.
Wu Jiang,Wu Shaowen,Chen Ming,et al.
(Department of P ediatric Surgery,The Affiliated Hospital of Guangdong Medical College,Zhanjiang 524001)
【Abstract】 Objective To study and make clear the cause of common compl ications due to loop transversostomy in neonates,and try to find out their preve ntion and treatment as well.Methods 37 cases of loop transversostom y in neonates were meticulously observed and closely followed up.Results Except 2 deaths there were 31 cases of dermatitis surrounding the stom a,19 cases of inflammatory polyps distributed all round the stomal mucosa,4 case s of stomal stenosis,4 cases of stomal prolapse and 2 cases of bowel adhesio n.Instead of transversostomy a sigmoidostomy per formed on the right upper quadrant as a result of carelessness was seen in two newborn infants.Conclusion Complications due to loop transvers ostomy often result from inexperienced practice or unskilled handicraft in o perative procedures.And the unsuitable or inadequate postoperative care is also a causative factor.Measures for their prevention and treatment have alread y been mentioned.
【Key words】 Neonate Loop transversostomy Complication
新生儿横结肠双腔造口术是为了使消化道连续性保持暂时通畅，确保婴幼儿正常生长， 有利于日后治疗原发病。横结肠双腔造口术虽然简单，但操作不当或术后护理不当，可带来 严重的并发症，甚至死亡。现将我院于1991～1997年间所行横结肠双腔造口术37例随诊报告 如下。
1 临床资料
1.1 一般情况
本组共37例，其中男32例，女5例。最大日龄25天，最小日龄1天。病种：先天性肛门闭 锁28例，先天性巨结肠7例，结肠穿孔2例。
1.2 手术方式
全组均行右上腹横结肠双腔造口术。
1.3 结果
本组病例均获随诊。除2例病儿术后1周内死于广泛性硬肿及呼吸衰竭外，其余均在1年 内治疗原发病和(或)关口术。造口术后并发症：造口周围皮炎31例，造口粘膜炎性息肉19例 ，造口狭窄4例，造口肠脱出4例，粘连性肠梗阻2例，误将乙状结肠作横结肠造口2例(同一 病儿可兼[1] [2] 下一页
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