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目的:分析先天性肠闭锁的病理组织学改变及其对肠道功能的影响,以探讨肠闭锁手术的切除范围。方法:对16例先天性肠闭锁手术切除之远近端肠管行 HE 染色,光镜下观察肠壁各层厚度及神经组织的改变及其范围。结果:在各型肠闭锁中,远近端肠管除肠壁厚度有改变外,各层神经丛及神经节细胞数均较正常明显减少,近端改变范围大于10cm,远端改变局限于2cm 内。在此范围内,随着远离闭锁盲端,上述指标均有逐渐增加的趋势。结论:本组结果从病理角度上对肠闭锁手术切除范围提供了理论依据,并对术后肠道功能恢复缓慢的现象给予解释。提出肠闭锁术后应依据具体情况合理延长 TPN 时间,以期患儿安全度过肠道功能自我逆转期。
OBJECTIVE: To analyze the histopathological changes of congenital intestinal atresia and its effect on intestinal function in order to explore the resection scope of intestinal atresia. Methods: 16 cases of congenital intestinal atresia resection of the distal bowel HE staining, the thickness of the intestinal wall and the changes in the scope and scope of the nerve tissue. Results: In all types of intestine atresia, in addition to intestinal wall thickness change, the number of layers of plexus and ganglion cells were significantly lower than normal, the proximal change range greater than 10cm, distal changes limited to 2cm. Within this range, the above-mentioned indicators tended to increase gradually as they were far away from the blind end of the lockout. Conclusion: The results of this study provide a theoretical basis for the resection of intestinal atresia from the pathological point of view, and explain the slow recovery of postoperative intestinal function. Proposed intestinal atresia should be based on the specific circumstances of a reasonable extension of TPN time, with a view to safety of children with intestinal self-reversion period.