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目的探讨先天性十二指肠梗阻的病因、临床表现、手术方法及术后处理。方法回顾性分析我院1993年10月至2010年10月期间治疗的26例先天性十二指肠梗阻患者的临床资料。结果 26例先天性十二指肠梗阻患者中肠旋转不良16例,行Ladd手术,其中1例因术中发现广泛肠坏死家属放弃治疗,其余15例痊愈。4例单纯十二指肠膈膜者行十二指肠膈膜切除术(纵切横缝),3例单纯十二指肠狭窄者行十二指肠空肠吻合术,均痊愈。单纯环状胰腺2例,行十二指肠-十二指肠菱形吻合术或十二指肠空肠吻合术后均痊愈。肠系膜上动脉压迫综合征1例,行十二指肠空肠吻合术后痊愈。结论先天性十二指肠梗阻是常见的新生儿急症,早期诊断,正确处理不同类型梗阻,加强围手术期处理,是提高治愈率的关键。
Objective To investigate the etiology, clinical manifestations, surgical methods and postoperative management of congenital duodenal obstruction. Methods The clinical data of 26 patients with congenital duodenal obstruction treated in our hospital from October 1993 to October 2010 were retrospectively analyzed. Results 26 cases of congenital duodenal obstruction in patients with duodenal dysplasia in 16 cases underwent Ladd surgery, of which 1 case of extensive intestinal necrosis were found in the treatment of family members abandoned, the remaining 15 patients recovered. Four cases of duodenal septum underwent duodenal resection (transverse incision), and three cases of duodenal stricture underwent duodenojejunostomy, all were cured. Simple annular pancreas in 2 cases, line duodenum - duodenal anastomosis or duodenum jejunum anastomosis were cured. One case of superior mesenteric artery compression syndrome was cured after duodenojejunostomy. Conclusions Congenital duodenal obstruction is a common neonatal emergency, early diagnosis, correct treatment of different types of obstruction, and strengthen the perioperative management, is the key to improve the cure rate.