Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Early Hum Dev. 2021 Nov;162:105459. doi: 10.1016/j.earlhumdev.2021.105459. Epub 2021 Sep 1.
Gastroschisis (GS) is a full-thickness abdominal wall defect in which fetal intestine herniates alongside the umbilical cord into the intrauterine cavity, resulting in an intestinal injury of variable severity. An increased prevalence of gastroschisis has been observed across several continents and is a focus of epidemiologic study. Prenatal diagnosis of GS is common and allows for delivery planning and treatment in neonatal intensive care units (NICUs) by collaborative interdisciplinary teams (neonatology, neonatal nursing and pediatric surgery). Postnatal treatment focuses on closure of the defect, optimized nutrition, complication avoidance and a timely transition to enteral feeding. Babies born with complex GS are more vulnerable to complications, have longer and more resource intensive hospital stays and benefit from standardized care pathways provided by teams with expertise in managing infants with intestinal failure. This article will review the current state of knowledge related to the medical and surgical management and outcomes of gastroschisis with a special focus on the role of the neonatologist in supporting integrated team-based care.
先天性腹壁裂（GS）是一种全层腹壁缺损，胎儿肠道通过脐带疝入子宫腔，导致不同严重程度的肠损伤。GS 在多个大洲的发病率均有所增加，是流行病学研究的重点。GS 的产前诊断较为常见，通过协作的多学科团队（新生儿科、新生儿护理和小儿外科）可以进行分娩计划和新生儿重症监护病房（NICU）治疗。产后治疗重点是关闭缺陷、优化营养、避免并发症，并及时过渡到肠内喂养。患有复杂 GS 的婴儿更容易出现并发症，住院时间更长，资源消耗更多，并且受益于由管理肠衰竭婴儿方面具有专业知识的团队提供的标准化护理路径。本文将回顾与 GS 的医疗和手术管理及结果相关的现有知识，特别关注新生儿科医生在支持基于团队的综合护理方面的作用。
