马能强　诸建明　李　勇宁波市妇女儿童医院小儿外科，浙江宁波　315012

先天性前腹壁缺损患儿行产房外科手术的预后分析

马能强诸建明李勇
宁波市妇女儿童医院小儿外科，浙江宁波315012

目的 探讨产房外科手术对先天性前腹壁缺损患儿的治疗价值。方法 回顾性分析我院2010年1月～2015年9月间收治的13例脐膨出、腹裂患儿的产房手术的临床资料，随访患儿术后的生长发育及营养状态，随访5～60个月。结果 13例患儿腹壁缺损均Ⅰ期关闭，7例腹裂患儿中1例术后放弃治疗，余6例随访均生长发育同同龄儿；6例脐膨出患儿1例因多发畸形，术后多次手术，发育慢于同龄儿童，余5例随访生长发育正常。结论 产房外科手术迅速终止疾病进展，增加Ⅰ期关闭腹腔机率，并明显改善患儿的预后。

腹裂；脐膨出；产房外科；预后

[Abstract]Objective To discuss the value of delivery room surgery in the treatment of children with congenital anterior abdominal wall defects.Methods From January 2010 to September 2015，13 patients with gastroschisis or omphalocele in our hospital who were given operations in the delivery room.the clinical data of patients were collected and followed-up the children's growth and nutrition status for 5-60 months.Results 13 cases were performedⅠperiod closed abdominal wall defect.About 1 in 7 cases in children with gastroschisis，postoperative give up treatment.The remained 6 cases follow-up growth with their peers.All in the 6 cases with omphalocele only one case growth was slower than the same age children because of multiple malformations and postoperative repeated operation.The remaining 5 patients followed for normal growth.Conclusion The delivery room surgery can quickly end disease progression，increased rate of primary repair and obviously improve the patient's prognosis.

[Key words]Gastroschisis;Omphalocele;Delivery room surgery;Prognosis

腹裂和脐膨出是影响婴儿的最常见的先天性前腹壁缺损[1，2]。在1970年之前，脐膨出发生更多，然而，由于两者更准确的定义，已发现腹裂也有较高的发病率，每4000例活产婴儿中有一例腹裂或脐膨出[3，4]。国外的流行病学统计[5]腹裂和脐膨出的死亡率分别达8%和20%，给患者和家庭带来了巨大的精神和经济负担。产房外科手术是指分娩后在产房或隔壁手术间立即对出生缺陷新生儿进行手术，常常要求出生后1 h内就进行手术干预。产房手术可及时修复先天性腹壁缺损，迅速除去病因终止疾病进一步进展，为争取最佳预后创造了条件。我院从2010年至今开展了13例先天性前腹壁缺损及时产房修复手术，现对其手术效果及临床预后进行回顾性分析，现报道如下。……