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婴幼儿及儿童膜性十二指肠狭窄的胃镜治疗:附6例报告

Gastroscopic treatment of membranous duodenal stenosis in infants and children: report of 6 cases.

作者信息

Huang Mao-Hua, Bian Hong-qiang, Liang Chong, Wei Wen-Qiong, Duan Xu Fei, Yang Jun

机构信息

Department of General Surgery, Wuhan Children Hospital, Wuhan 430016, China.

Department of General Surgery, Wuhan Children Hospital, Wuhan 430016, China.

出版信息

J Pediatr Surg. 2015 Mar;50(3):413-6. doi: 10.1016/j.jpedsurg.2014.10.045. Epub 2014 Dec 17.

Abstract

OBJECTIVE

To investigate the efficacy of gastroscopic treatment in the treatment of membranous duodenal stenosis.

METHODS

We performed a retrospective study of 6 patients with membranous duodenal stenosis, aging from 7days to 37months, who underwent gastroscopic balloon dilatation in a children's hospital between January 2012 and December 2013. All surgical procedures of balloon dilatation were performed under direct gastroscopic vision. The balloon dilators with diameter 8mm and 10mm for neonates and children aged over one month, respectively, were placed through the foramen of the membranous stenosis. The septum in the membranous stenosis was gradually extended by increasing diameter of the balloon dilator. The residual septum was removed by gastroscopic electrocauterization.

RESULTS

The membranous stenosis in duodenum of all children was successfully expanded by gastroscopic balloon dilatation, and only one case with residual septum received gastroscopic electrocauterization. No complications such as bleeding, intestinal perforation, etc., were observed. Postoperative radiography using iodine-based contrast media showed that the gastrointestinal tract was unobstructed. During a follow-up period ranging from 3 to 24months, all patients ate normally without vomiting and abdominal distension and grew normally.

CONCLUSION

Gastroscopic balloon dilatation is an effective method in the treatment of membranous duodenal stenosis in children. For the patients with residual septum, they can be cured by using gastroscopic electrocauterization.

摘要

目的

探讨胃镜治疗膜性十二指肠狭窄的疗效。

方法

对2012年1月至2013年12月在某儿童医院接受胃镜下球囊扩张术的6例膜性十二指肠狭窄患儿进行回顾性研究,患儿年龄7天至37个月。所有球囊扩张手术均在胃镜直视下进行。分别选用直径8mm和10mm的球囊扩张器,经膜性狭窄孔道置入,用于新生儿及1个月以上儿童。通过增加球囊扩张器直径逐步扩张膜性狭窄处的隔膜,对残留隔膜行胃镜下电灼切除。

结果

所有患儿十二指肠膜性狭窄均经胃镜下球囊扩张成功,仅1例残留隔膜患儿行胃镜下电灼切除。未观察到出血、肠穿孔等并发症。术后使用碘造影剂行X线检查显示胃肠道通畅。随访3至24个月,所有患儿进食正常,无呕吐、腹胀,生长发育正常。

结论

胃镜下球囊扩张术是治疗儿童膜性十二指肠狭窄的有效方法。对残留隔膜患儿,可行胃镜下电灼切除治愈。

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