王柏毅

[摘要] 目的 分析小儿肠造瘘的临床治疗效果以及临床特点。 方法 方便选取2006年2月—2016年10月收治的20例肠造瘘患儿作为该研究对象，对其临床特点进行分析并制定相应治疗方案。 结果 20例肠造瘘患儿中，结肠造瘘8例，小肠造瘘12例，双口造瘘9例，单口造瘘11例，所有患儿均接受随访，均II期顺利关闭造瘘口。其造瘘口关闭的时间为：小肠首次造瘘术后0.6～3个月，平均（1.48±0.42）个月；结肠造瘘术后2.2～10.8个月，平均（7.21±1.42）个月，其中6例患儿于关瘘术后产生并发症，其切口感染4例，占比66.67%，经换药后，其切口均痊愈，切口裂开1例，占比16.67%，肠粘连梗阻再次予以手术者1例，占比占比16.67%。 结论 予以小儿肠造瘘术时应依据其病情选择手术时机，并确定手术方法及部位，且II期关瘘时间尤为关键，与小儿的疾病预后情况具有密切关系。

[关键词] 小儿肠造瘘；临床特点；治疗效果；并发症

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0042-03

[Abstract] Objective To analyze the clinical treatment effect and clinical features of colostomy in children. Methods 20 cases of children with colostomy admitted and treated in our hospital from February 2006 to October 2016 were conveniently selected and the clinical features were analyzed and the corresponding treatment plans were made. Results Of 20 cases of children with colostomy， there were 8 cases with colostomy， 12 cases with jejunostomy， 9 cases with double ported fistulization and 11 cases with single ported fistulization， and all patients were followed up and successfully closed anastomosis during the II stage， and the anastomosis closure time was： in 0.6 months to 3 months after the first colostomy，（1.48±0.42） months on average； in 2.2 months to 10.8 months after colostomy（7.21±1.42） months on average， and complications occurred to 6 cases after the fistula closure， and 4 cases were with incision infection， accounting for 66.67%， after dressing changes， the cut length was cured and 1 case was with wound dehiscence， accounting for 16.67% and 1 case was with second surgery due to intestinal obstruction， accounting for 16.67%. Conclusion We should select the operation opportunity at the colostomy in children according to the disease condition and determine the operation method and site， and the fistula closure time during II stage is the key， which is closely related to the disease prognosis of children.

[Key words] Colostomy in children； Clinical features； Treatment effect； Complication

腸造瘘术为腹外科常见疾病常见治疗手段[1]，针对于肠坏死并休克、绞窄型肠梗阻、腹腔感染、消化道畸形及严重脱水性酸中毒具有显著效果。但于术后易产生较多并发症[2]，如处理不当会对患儿的生长发育造成严重负面影响。该院为探讨小儿肠造瘘的临床治疗效果以及临床特点，回顾性分析2006年2月—2016年10月收治的20例肠造瘘患儿作为该研究对象，对其临床特点进行分析并制定相应治疗方案，患儿于肠造瘘术后均已痊愈、出院，该研究总结出予以手术时须依据其病情选择手术时机，并确定手术方法及部位，掌握并制定科学的II期关瘘时期，可降低患儿术后并发症，以此保障生命安全，提高生活质量，现报道如下。……