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目的探讨新生儿先天性十二指肠梗阻的诊治方法和病理特点。方法总结近7年收治的43例新生儿先天性十二指肠梗阻的临床资料,对术前诊断、病理类型及治疗方法进行回顾性分析。结果43例患儿术前均行X光立位腹部平片检查,20例行上消化道泛影葡胺造影检查,12例行钡灌肠检查,所有患儿均行手术治疗,手术证实先天性肠旋转不良22例,十二指肠闭锁及狭窄11例,环状胰腺4例,环状胰腺合并肠旋转不良3例,肠旋转不良合并十二指肠狭窄2例,十二指肠周围异常韧带1例。治愈41例,死亡2例。结论术前X线检查是诊断新生儿先天性十二指肠梗阻的有效方法,新生儿先天性十二指肠梗阻的主要原因是先天性肠旋转不良、十二指肠闭锁和狭窄、环状胰腺,部分患儿有多种原因。早期诊断、合理选择手术方法、避免漏诊、加强围手术期处理是提高治愈率的关键。
Objective To investigate the diagnosis and treatment of neonatal congenital duodenal obstruction and pathological features. Methods The clinical data of 43 cases of neonatal congenital duodenal obstruction admitted in recent 7 years were summarized. The preoperative diagnosis, pathological type and treatment were retrospectively analyzed. Results 43 cases of children underwent preoperative X-ray examination of abdominal plain film, 20 cases of upper gastrointestinal meglumine diaphragmatic contrast examination, 12 cases of barium enema examination, all children underwent surgical treatment, surgery confirmed congenital 22 cases of poor bowel rotation, 11 cases of duodenal atresia and stenosis, 4 cases of annular pancreas, 3 cases of annular pancreas with intestinal malrotation, 2 cases of poor bowel malposition combined with duodenal stricture, Ligament in 1 case. 41 cases were cured and 2 died. Conclusions Preoperative X-ray examination is an effective method to diagnose congenital duodenal obstruction in newborns. The main causes of congenital duodenal obstruction in newborns are congenital intestinal malrotation, atresia and stenosis of the duodenum, Pancreas, some children have a variety of reasons. Early diagnosis, reasonable choice of surgical methods to avoid misdiagnosis, strengthen the perioperative management is the key to improve the cure rate.