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目的介绍非麻醉状态下于床边应用免缝Silo袋分期处理无法I期关闭的新生儿腹裂。方法2004年3月和7月,收治2例新生儿腹裂,分别出生后2h和4h,1例肠管污染严重,另1例合并有肠旋转不良和胎粪性肠梗阻,2例均在清醒状态下于NICU床边应用免缝Silo袋I期处理无法回纳腹腔的肠管,2例分别于第6d和第7d在肠管完全回纳腹腔后至手术室全麻下行腹壁关闭脐部成形术,其中例2同期行Ladd′s术和肠内胎粪清除术。结果2例患儿术后恢复好,脐部Ⅰ期愈合,分别随访5个月和2个月,生长发育好。结论非麻醉状态下床边应用免缝Silo袋分期处理无法I期回纳的新生儿腹裂是一简便安全的方法,并可推广至产房早期处理腹裂患儿,将有效减少患儿肠管的继发性水肿和炎症,提高生存率。
Objective To introduce the non-anesthetic state at the bedside application of free sutureless Silo bag staging I can not close off the newborn infantile fissure. Methods Two cases of neonatal ascites were treated in March and July 2004, 2 cases and 4 hours after birth, respectively. One case had serious intestinal pollution and the other case had intestinal malrotation and meconium ileus. Both cases were awake Under the condition of NICU bed application free seam Silo bag I can not return to the abdominal cavity of the intestine, 2 cases were on the 6d and 7d in the bowel completely back into the abdominal cavity to the operating room after anesthesia under general anesthesia umbilical placenta, Among them, 2 cases of concurrent Ladd’s surgery and enteral meconium removal. Results 2 cases of children recovered well, umbilical first phase healed, were followed up for 5 months and 2 months, good growth and development. Conclusion The non-anesthesia bedside application of free suture-free Silo sachet can not be recapitulated I-stage neonate gastroglyphs is a simple and safe method, and can be extended to the delivery room early treatment of children with abdominal cracking, will effectively reduce the intestinal Secondary edema and inflammation, improve survival.