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目的探讨先天性消化道畸形患儿的临床特征,以利于早期诊断、选择恰当手术时机、提高存活率。方法选择2011年2月至2013年6月在湖南省儿童医院新生儿外科住院并确诊为先天性消化道畸形的患儿,分析其临床资料,总结发病特征、治疗过程及转归。结果研究期间共收治142例先天性消化道畸形患儿,畸形种类以肛门直肠畸形、先天性巨结肠症、先天性肥厚性幽门狭窄比例最高,分别占27.5%、19.0%、12.7%。生后1天内发病比例最高,生后5天内发病占69.7%。呕吐、腹胀、胎便异常为先天性消化道畸形的主要临床表现,分别占主诉的55.6%、34.5%、18.3%。以呕吐为主要表现的病例就诊要普遍早于腹胀、排便异常为主诉的病例。呕吐后引起的电解质紊乱占26.1%,营养不良占17.8%。结论在我院统计的142例先天性消化道畸形患儿中,发病种类以肛门直肠畸形、先天性巨结肠症、先天性肥厚性幽门狭窄位居前三位。发病时间在生后1天内最多,呕吐为最主要的临床表现,呕吐后引起的电解质紊乱和营养不良为主要并发症。
Objective To investigate the clinical features of children with congenital gastrointestinal malformations in order to facilitate early diagnosis, select the appropriate timing of surgery to improve the survival rate. Methods From February 2011 to June 2013 in Children’s Hospital of Hunan Province neonatal surgery hospitalized and diagnosed as congenital gastrointestinal malformations in children, analysis of clinical data, summarize the incidence characteristics, treatment and outcome. Results During the study period, 142 cases of children with congenital gastrointestinal malformations were treated. The malformations included anorectal malformations, Hirschsprung’s disease and congenital hypertrophic pyloric stenosis with the highest proportion, accounting for 27.5%, 19.0% and 12.7%, respectively. The incidence of one day after birth the highest incidence of 5 days after birth incidence of 69.7%. Vomiting, abdominal distension and meconium as the main clinical manifestations of congenital gastrointestinal malformations accounted for 55.6%, 34.5% and 18.3% respectively. Vomiting as the main manifestation of cases to be generally earlier than abdominal distension, defecation abnormalities as the main complaint. Electrolyte disturbance caused by vomiting accounted for 26.1%, malnutrition accounted for 17.8%. Conclusion In our hospital, 142 cases of congenital gastrointestinal malformations in children, the incidence of type anorectal malformation, Hirschsprung disease, congenital hypertrophic pyloric stenosis among the top three. The onset time in most days after birth, vomiting for the most important clinical manifestations, electrolyte imbalance caused by vomiting and malnutrition as the main complication.