新生儿先天畸形围术期的治疗探讨.DOCVIP

临床医学论文-新生儿先天畸形围术期的治疗探讨 【摘要】? 目的 回顾小儿外科自2002年1月至2009年5月收治的先天性畸形患儿104例治疗的临床资料，探讨新生儿先天性畸形的有效治疗方法。方法 先天性畸形患儿入院后，详细询问病史，母亲的孕期服药史，羊水情况，胎动情况，产前胎儿系统查体情况，以及患儿出生后的表现如呕吐、排便等，仔细全面体格检查，辅助检查，明确诊断。经过完善的术前准备，良好的麻醉支持，精细的外科手术，完备的术后护理，患儿康复出院。结果 在收治的104例患儿中，其中87例达到一期治愈，占87.8%;12例出现腹部刀口感染，二期手术治愈;1例先天性胃壁肌层缺损并破裂者，合并硬肿症而死亡;3例回肠末端闭锁者，因就诊时间晚，出现电解质紊乱，肺部感染而死亡。1例先天性十二指肠闭锁并小肠多端闭锁,放弃治疗。随访发现安全渡过围术期患儿生长发育正常。结论 随着麻醉技术的提高，小儿外科医生操作技术水平的进步，护理人员耐心细致的护理，以及高新材料的临床应用，只要重视每一个临床细节并使之完善，新生儿先天畸形的治愈率将会越来越高。 【关键词】? 新生儿;先天畸形;围术期 Perioperational therapy in newborn with congenital malformation 　　WANG Shou-guo,ZHANG Zheng-mao.Department of Pediatric Surgery,Maternal and Child Health Hospital of Zibo City,Zibo 255029,China 　　[Abstract] Objective This paper aims to explore the effective therapy for newborn with congenital malformation after 104 cases of neonatal abnormalities from January 2002 to May 2009 were reviewed and analyzed in department of pediatric surgery of our hospital.Methods After being hospitalized,the newborns with congenital malformation were checked from inquiry about their medical histories,their mothers prenatal medication,conditions about amniotic fluid,fetal movement,systematic antenatal physical examination as well as manifestation like vomit and defecation after being born.Conducted double and overall physical check and accessory examination,clarified the diagnosis.Fully preparation before operation which is aided with good anaesthesia,subtle surgery and complete postoperative care can make these neonatal abnormalities recovere from the hospital.Results 104 newborns all received an operation.87 (87.8%) cases were cured after one-stage operation.12 cases got abdominal blade infection,and were cured after two-stage operation.1 case died because of congenital defect of muscular layer of stomach wall and mucous membrane got rupture after taking food,incorporated with scleredema.3 cases with distal ileum atresia died from paying a late visit to doctor,suffered from electrolyte disturbances and pul