先天性腹裂伴脐膨出患者的早期预后

S. Berdawd, Abdulrahman Omar Taha
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引用次数: 0

摘要

背景:腹裂和脐膨出是最常见的前腹壁先天性缺陷,需要紧急和及时的干预。不同国家,特别是发达国家和发展中国家,腹裂和脐膨出的术后预后存在差异。目的:确定出生时胃裂合并脐膨出患者的早期预后。方法:对2015 -2018年在埃尔比勒市治疗的30例患者(11例胃裂和19例脐膨出)进行分析研究。排除伴有膀胱和肛管外翻的患者。结果:男女比例为1.3:1,平均发病年龄为11.7 h。平均体重2.86 kg。大多数患者25(83.3%)为中期。顺产19例(63.3%),其中腹裂9例,脐膨出10例,产前诊断9例(30%)。缺陷的平均尺寸为3.7cm,含量混合在7个(23.3%)。18例(60%)进行了初步修复,8例(26.7%)进行了修复,4例(13.3%)未进行手术治疗(均为脐膨出)。16例(61.5%)在抵达后24小时内完成手术。11例脐膨出(57.9%)和2例腹裂(18.2%)存在相关异常。平均住院时间为6 d。胃裂患者死亡率为8例(72%),脐膨出患者死亡率仅为4例(21.1%)。结论:胃裂和脐膨出是新生儿外科问题的重要组成部分,其治疗仍具有挑战性。如果相关异常局限于胃肠道,脐膨出病例更有可能伴有先天性异常和胃裂。由于缺乏重症监护病房、设施和训练有素的人员来照顾这些高危患者,因此死亡率很高,特别是胃裂和脐膨出破裂的患者。
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Early Outcome of Patient Born with Gastroschisis and Omphalocele
Background: Gastroschisis and omphalocele are the most common congenital defects of the anterior abdominal wall which need urgent and prompt intervention post-operative time outcomes of gastroschisis and omphalocele differ between different countries, especially between developed and developing countries. Objectives: Is to determine the early outcome of patients born with gastroschisis and omomphalocele Patients and Methods: An analytical study including 30 patients (11 gastroschisis and 19 omphaloceles) were treated in Erbil city during 2015 -2018. Patients with associated bladder and cloacal exstrophies were excluded. Results: Female to male ratio was 1.3:1, and the mean age at presentation was 11.7 hours. The Mean weight was 2.86 kg. the Majority of patients25 (83.3%) were term. In Nineteen cases (63.3%)were delivered vaginally (9 gastroschisis and 10comphalocele), prenatally diagnosis was done in 9(30%). The Mean size of the defect was 3.7cm, and the content was mixed in 7(23.3%). Primary repair has performed in 18(60%), a silo in 8(26.7%), and 4(13.3%) treated none surgically (all were omphalocele). Operations have been done within 24 hours of arrival in 16(61.5%). Associated anomalies have been found in 11(57.9%) patients with omphaloceles and only 2(18.2%) patients with gastroschisis. The mean period of hospital stays was6 days. Mortality among the gastroschisis patients were 8(72%), but only 4(21.1%) for omphalocele patients. Conclusion: Gastrochisis and omphalocele constitute a considerable part of neonatal surgical problems and their management is still challenging. Omphalocele cases were more likely to have associated congenital anomalies and gastroschisis, if the associated anomalies were confined to the gastrointestinal tract. There was a high mortality rate, especially in patients with gastroschisis and ruptured omphalocele due to a lack of intensive care units, facilities, and trained personnel to look after such high-risk patients.
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