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目的:通过16例临床资料的回顾对小儿食管裂孔疝的外科治疗作进一步探讨。方法:本组共16例,男性9例,女性7例,年龄1个半月～8岁,其中12例≤2岁,临床分型:滑疝11例(合并短食管畸形3例)。旁疝3例,混合型2例。除完成裂孔疝修补外,滑疝、混合型疝均附加抗返流手术,其中2例又加幽门成形术,8例加幽门浆肌层切开术。结果:术后死亡1例,1例滑疝术后因吞咽困难再手术治愈,3例轻度胃胀气,1～2月症状消失,15例随访1～4年无复发。结论:重症小儿食管裂孔疝应积极采取手术治疗,滑疝,混合型疝除完成疝修补外须附加抗返流手术,疗效满意。
Objective: To further investigate the surgical treatment of hiatal hernia in children through the review of 16 clinical data. Methods: A total of 16 cases were included in this study. There were 9 males and 7 females, ranging in age from 1 month and a half months to 8 years old. Twelve of them were ≤2 years old. The clinical classification was as follows: 11 cases of sliding hernia (3 cases with short esophageal malformations). 3 cases of hernia, mixed 2 cases. In addition to the completion of hiatal hernia repair, the sliding hernia, hybrid hernia were added anti-reflux surgery, of which 2 cases plus pyloroplasty, 8 cases of pyloric myometrial incision. Results: One patient died of postoperative death, one was cured by swallowing hernia after operation, 3 patients had mild flatulence and symptoms disappeared from January to February. No recurrence was found in 15 cases 1 to 4 years follow - up. Conclusion: Severe pediatric hippocampal hiatal hernia should be actively taken surgical treatment, sliding hernia, mixed hernia in addition to complete repair of hernia should be additional anti-reflux surgery, the effect is satisfactory.