摘要
目的探讨硅胶袋整复与局部压迫治疗新生儿巨型脐膨出的疗效。方法回顾性分析青岛市妇女儿童医院2010年10月至2017年4月收治的16例新生儿巨型脐膨出患儿的病例资料,在保护羊膜囊完整的同时,将膨出内容物纳入无菌硅胶袋,进一步将无菌硅胶袋与腹壁缺损边缘皮肤缝合,逐渐挤压收紧硅胶袋,1～2个月去除硅胶袋,改用自制半球形纱布袋加压包扎,创面用湿润烧伤膏外敷,观察治疗效果。结果 16例巨型脐膨出患儿中,12例膨出物逐渐完全还纳,腹壁逐渐生长直至缺损处完全愈合,形成接近自然脐部形态。1例于生后2个月行"巨型脐膨出修补术+膈疝修补术",3例未完全回纳,但创面完全上皮化,2～3年后行脐部修补整形术。所有病例随访5个月至6年,患儿脐部外观均满意,发育良好,无并发症和死亡病例。结论对于巨型脐膨出患儿采取保留羊膜囊、硅胶袋整复、局部压迫治疗及择期行脐部修补整形术的方法,能够提高新生儿巨型脐膨出的治愈率,降低病死率。
Objective To explore the therapeutic efficacy of giant neonatal omphalocele adopting with silica bag plus local pressing.Methods A total of 16 cases of neonatal giant omphalocele were retrospectively analyzed from October 2010 to April 2017.For protecting the integrity of amniotic sac,sterile silica bag was used for wrapping protruding viscera and sutured with the edge of abdominal wall.Protruding viscera were gradually returned into abdominal cavity.Silica bag was extracted after 1-2 months.Then a semi-spherical gauze bag was adopted for pressure bandaging.MEBO cream was applied to observe the therapeutic efficacy.Results Among them,the protruding viscera of 12 cases were placed in abdominal cavity.Abdominal wall gradually healed like a natural umbilicus.Repairing of giant omphalocele and diaphragmatic hernia was performed for 1 case after 2 months.The protruding viscera of 3 cases were not fully returned.Yet wound became completely epithelialized.And omphalocele repair was conducted after 2-3 years.All cases was followed up for 5 months to 6 years.Umbilical regions of all cases showed satisfactory appearances.All developments were excellent and there was neither complication nor mortality.Conclusion For protecting the integrity of amniotic sac,reconstruction with silica bag plus local pressing and elective omphalocele repair are effective and efficacious.It may improve the cure rate and decrease the mortality for neonatal giant omphalocele.
作者
孙健
祁泳波
张磊
高强
李良辉
鹿洪亭
Sun Jian;Qi Yongbo;Zhang Lei;Gao Qiang;Li Lianghui;Lu Hongting(Department of Pediatric Surgery,Municipal Women&Children s Hospital,Qingdao,266000,China;Department of General Surgery,Affiliated Hospital,Qingdao University,Qingdao,266000,China;Maternal&Child Health Care of Family Planning Service Center,Qingdao 266000,China;Department of Pediatric Surgery,Affiliated Hospital,Qingdao University,Qingdao 266000,China)
出处
《临床小儿外科杂志》
CAS
2018年第10期55-58,共4页
Journal of Clinical Pediatric Surgery
基金
山东省医药卫生科技发展计划项目(编号:2014WS 0179)
关键词
脐膨出
新生儿
硅胶袋整复
局部压迫
Omphalocele
Neonate
Reconstruction With Silica Bag
Local Pressing
