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目的探讨新生儿巨型脐膨出一期手术治疗的手术方式、治疗效果及围术期处理方法。方法对本院1994年2月-2008年4月收治的18例巨型脐膨出新生儿临床资料进行回顾性分析。男11例,女7例;入院时年龄为5h～8d;出生体质量1.9～4.3kg;腹壁缺损直径6～9cm。14例通过一期手术缝合修补脐部缺损,术后使用呼吸机支持、营养对症治疗;1例腹壁缺损9cm,一般情况差,游离皮肤与透明膜,并将透明膜完全包埋于皮下,腹壁、腹膜未行修补,行二期手术修补腹壁。采用电话、信件及门诊随访,对患儿生长发育、日常生活进行随访观察,随访1～11a。结果 14例患儿经一期手术及围术期处理均治愈,无切口疝、切口裂开发生;3例因入院较晚,并严重感染且未得到有效治疗而死亡;1例行二期手术治愈。随访所有患儿生长发育正常,日常生活无障碍。结论巨型脐膨出患儿经及时一期手术治疗及围术期处理,疗效满意。
Objective To investigate the surgical methods, therapeutic effects and perioperative management of neonatal giant umbilical bulging. Methods The clinical data of 18 cases of giant umbilical bulging neonates admitted to our hospital from February 1994 to April 2008 were analyzed retrospectively. 11 males and 7 females; the age of admission was 5h ~ 8d; the birth weight was 1.9 ~ 4.3kg; the diameter of abdominal wall defect was 6 ~ 9cm. 14 cases of suture through an operation to repair umbilical defects, postoperative use of ventilator support, nutrition symptomatic treatment; 1 case of abdominal wall defect 9cm, the general situation is poor, free skin and transparent membrane, and the transparent membrane completely embedded in the skin, abdominal wall , The peritoneum is not repaired, the line of surgery to repair the abdominal wall. By telephone, letters and out-patient follow-up, children’s growth and development, daily life follow-up observation, follow-up 1 ~ 11a. Results All the 14 cases were cured by one-stage operation and perioperative management. There were no incisional hernias and incisions in the incisions. Three patients died after hospitalization and severe infection without effective treatment. One case underwent second-stage operation cure. All children were followed up for growth and development, daily life without barriers. Conclusion Giant umbilical swelling in children with a timely surgical treatment and perioperative management, the effect is satisfactory.