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[发展中国家脐膨出的治疗方法:科特迪瓦阿比让约普贡中央大学医院的经验]

[Therapeutic approaches for omphalocele in developing countries: experience of Central University Hospital of Yopougon, Abidjan, Côte d'Ivoire].

作者信息

Kouamé B D, Dick R K, Ouattara O, Traoré A, Gouli J C, Dieth A G, da Silva A, Roux C

机构信息

Centre Hospitalier et Universitaire de Yopougon, Service de chirurgie pédiatrique viscérale et orthopédique, 21 BP 632 Abidjan 21, Côte d'Ivoire.

出版信息

Bull Soc Pathol Exot. 2003 Nov;96(4):302-5.

Abstract

A retrospective study about 80 cases of exomphalos treated in the digestive unit of the paediatric surgery department in Abidjan teaching hospital--Côte d'Ivoire had been performed to analyse the result of this malformation treatment during 8 years. Prenatal diagnosis was made in two cases on six antenatal ultrasounds. Prematurity involved 7% of newborn and their birth weight ranged from 2500 to 4000 grams in 70% of cases. Treatment began in 64% at birth, conservative treatment with merbromine tannage was systematic on the non disrupted exomphalos. Surgery was indicated in the disrupted exomphalos and in the complicated cases of conservative treatment. Intestinal occlusion was the main fatal complication observed in both treatments but most of the time it occurred with surgical closure. Total lethality reached 30%, influenced by exomphalos super infection and by neonatal resuscitation insufficient means. Authors think exomphalos lethality reduction implies antenatal ultrasonographic for early diagnosis which could indicate a possible caesarian section in case of the voluminous exomphalos in order to prevent disruption and neonatal resuscitation operation.

摘要

对科特迪瓦阿比让教学医院小儿外科消化科治疗的80例脐膨出病例进行了一项回顾性研究,以分析8年来这种畸形治疗的结果。在6次产前超声检查中,有2例进行了产前诊断。早产涉及7%的新生儿,70%的病例出生体重在2500至4000克之间。64%的病例在出生时开始治疗,对于未破裂的脐膨出,系统地采用汞溴红鞣皮进行保守治疗。对于破裂的脐膨出和保守治疗的复杂病例,则进行手术治疗。肠梗阻是两种治疗中观察到的主要致命并发症,但大多数情况下发生在手术闭合时。总死亡率达到30%,受脐膨出超级感染和新生儿复苏手段不足的影响。作者认为,降低脐膨出死亡率意味着进行产前超声检查以早期诊断,对于巨大脐膨出病例,这可能意味着进行剖宫产,以防止破裂和新生儿复苏手术。

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