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目的探讨产前超声早期诊断出消化道梗阻性疾病对患儿出生后手术前瞻性指导和改善预后的意义。方法 新生儿消化道梗阻并手术治疗的患儿138例。92例产前超声已确诊消化道梗阻的患儿为观察组,46例出生后确诊为消化道梗阻的患儿为对照组。观察组患儿经多学科会诊(multi-disciplinary team,MDT)后进行围手术期处理,产后早期手术。对照组患儿经MDT后择期手术。观察记录两组患儿术后恢复自主呼吸比率、治愈率、住院时间和预后情况。结果观察组患儿较对照组术前准备明显更为充分,手术并发症较少,术后恢复自主呼吸而不必使用呼吸机比率较高分别为83.7%和67.4%,P<0.05,住院时间分别为(12±4.1)天和(14±4.3)天,P<0.05,门诊随访预后较好。结论产前超声检查是早期确诊小儿消化道梗阻性疾病的重要手段。超声确诊后早期干预,可以提前完善术前准备,提高手术成功率和治愈率。
Objective To investigate the significance of prenatal ultrasound in the early diagnosis of gastrointestinal obstruction in children after surgery for prospective guidance and improve prognosis. Methods Newborns with gastrointestinal obstruction and surgical treatment of 138 cases of children. 92 cases of prenatal ultrasound confirmed digestive tract obstruction in children as the observation group, 46 cases were diagnosed as gastrointestinal obstruction after birth as control group. The observation group received perioperative management after multi-disciplinary team (MDT) and early postnatal surgery. The control group of children underwent elective surgery after MDT. The recovery rate of spontaneous respiration, the cure rate, length of hospital stay and prognosis of the two groups were observed and recorded. Results Compared with the control group, the observation group had significantly more preoperative preparation, fewer complications and no respirable respiration rate after surgery, respectively, 83.7% and 67.4%, P <0.05, and hospital stay respectively (12 ± 4.1) days and (14 ± 4.3) days, P <0.05, outpatient follow-up with good prognosis. Conclusion Prenatal ultrasound is an important means of early diagnosis of obstructive diseases of the digestive tract in children. Early diagnosis after ultrasound intervention, preoperative preparation can be improved ahead of schedule to improve the success rate and cure rate.