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目的总结十二指肠膜式狭窄与闭锁的诊断及治疗经验。方法回顾性分析2002年1月-2010年12月本中心收治的19例十二指肠膜式狭窄与闭锁患儿的临床资料,主要包括临床表现、诊断方式、手术方式及治疗效果。探讨各年龄段十二指肠膜式狭窄的临床特点。结果 19例患儿中男10例,女9例;年龄5 d～3岁2个月,其中新生儿(5～19 d)10例,年长儿(1～3个月3例;1～3岁6例)9例。临床表现均以反复呕吐为主要症状。术中见新生儿组隔膜有孔占40%(4/10例);年长组隔膜有孔占100%(7/7例),2例放弃治疗,出院后不久即死亡。手术患儿中2例死于并发症(甲状腺功能减低,先天性短肠综合征),其余手术患儿治疗效果良好。结论十二指肠膜式狭窄与闭锁通常发生在新生儿期且有典型临床症状,年长儿有上消化道梗阻症状时应考虑该病的可能。肠腔内隔膜切除是治疗十二脂肠膜式狭窄的一种简单、有效的手术方式。
Objective To summarize the diagnosis and treatment experience of duodenal stenosis and atresia. Methods The clinical data of 19 children with duodenal stricture and atresia admitted from January 2002 to December 2010 were retrospectively analyzed. The clinical manifestations included the clinical manifestations, diagnosis methods, surgical modalities and therapeutic effects. To investigate the clinical features of duodenal stenosis of all ages. Results There were 10 males and 9 females in 19 cases. There were 10 newborns (5 ~ 19 days), 10 elderly infants (1 ~ 3 months), 1 ~ 3 years old and 6 cases) 9 cases. Clinical manifestations are repeated vomiting as the main symptoms. Surgery, see the neonatal membrane hole accounted for 40% (4/10 cases); elderly group of diaphragm hole accounted for 100% (7/7 cases), 2 patients give up treatment, died soon after discharge. Two of the children with surgery died of complications (hypothyroidism, congenital short bowel syndrome) and the rest of the children had good outcomes. Conclusions Duodenal membrane stenosis and atresia often occur in neonates with typical clinical symptoms. The elderly may have the possibility of upper gastrointestinal obstruction symptoms. Removal of intestine diaphragm is a simple and effective surgical approach for the treatment of 12-lipo-intestinal stenosis.