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腹壁裂患儿的腹腔外露肠管经常是炎性水肿、缩短并增厚,表面覆盖有不同程度的胶冻样物质。这些外露肠管的异常表现可能与以下因素有关:①直接暴露于羊水中并接触刺激性物质;②腹壁裂环状缺损压迫肠系膜从而导致慢性静脉回流障碍。另外暴露肠管的慢性变化常伴有肠道消化酶生成的减少以及胃肠蠕动功能受到影响,因而在修复术后,受累肠管仍在不同的时间内表现出吸收及蠕动功能的障碍。这些产前(宫内)因素所致的异常表现直接关系列腹壁裂术后的合并症,这也是患儿住院时间长的首要原因。据报道,肠管的这些变化主要出现于妊娠末期。因此一些人提出患有腹壁裂的胎儿应全部或选择性地实施提前终止妊娠,使其在宫内暴露肠管受到
Abdominal perforation of infants with abdominal wall cracked bowel often inflammatory edema, shortening and thickening, the surface covered with different levels of jelly-like material. Abnormal performance of these excretory bowel may be related to the following factors: ① direct exposure to amniotic fluid and exposure to irritating substances; ② abdominal wall ring-shaped defect pressure mesenteric compression resulting in chronic venous return disorders. In addition, chronic bowel changes are often accompanied by reduced production of intestinal digestive enzymes and gastrointestinal motility affected, and therefore in repair, the affected intestine still show absorption and peristalsis at different times obstacles. These abnormalities caused by these prenatal (intrauterine) factors are directly related to comorbidities after perforation of the abdominal wall, which is also the leading cause of hospitalization for a long period of time. It is reported that these changes in the intestine occur mainly in the end of pregnancy. Therefore, some have suggested that a fetus with a ruptured abdominal wall should have full or selective premature termination of pregnancy and expose the intestine to intrauterine exposure