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加强脐膨出护理:应对并发症及创新治疗方法

Enhancing Omphalocele Care: Navigating Complications and Innovative Treatment Approaches.

作者信息

Malhotra Ritika, Malhotra Bhavana, Ramteke Harshal

机构信息

Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institue of Higher Education and Research, Wardha, IND.

Paediatrics, Deep Chand Bandhu Hospital, New Delhi, IND.

出版信息

Cureus. 2023 Oct 25;15(10):e47638. doi: 10.7759/cureus.47638. eCollection 2023 Oct.

DOI:10.7759/cureus.47638
PMID:38021990
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10667945/
Abstract

Congenital abdominal wall abnormalities in infants present an interesting and difficult management problem for surgeons. Congenital malformations of the ventral abdominal wall can be diagnosed by their distinctive anatomical presentations. Among them, omphalocele, gastroschisis and umbilical cord hernias are the most frequently observed clinically detected abdominal wall anomalies. Omphalocele refers to the herniation of abdominal contents through a defect in the abdominal wall at the umbilicus with or without the presence of a sac. This article gives an insight into the embryology, risk factors, treatment, investigations and complications of omphalocele, a common congenital abdominal wall defect. There is minimal proof that environmental factors contribute to the development of omphalocele. However, there is a considerable amount of evidence which points to the importance of genetic or familial risk factors. Newborns and infants with prenatal diagnoses are the most frequently presenting patients with omphalocele to paediatric surgeons. This article describes the problems and the steps of management for handling each circumstance, as well as any further complications. Omphalocele and gastroschisis are frequently described together in many research papers. However, it's crucial to consider that they are two different conditions which vary in anatomy, pathology and associated conditions which account for the difference in their treatments and noticeably varied outcomes. Additionally, there is evidence that each has a different set of factors associated with risk for occurrence. There are no known etiologic causes that cause these abnormalities to develop. The size of the baby, the extent of the lesion, and any other disorders all affect how individuals with these congenital abdominal wall anomalies are treated.

摘要

婴儿先天性腹壁异常给外科医生带来了一个有趣且棘手的管理问题。腹前壁的先天性畸形可通过其独特的解剖表现来诊断。其中,脐膨出、腹裂和脐疝是临床上最常观察到的腹壁异常。脐膨出是指腹腔内容物通过脐部腹壁缺损突出,可伴有或不伴有囊。本文深入探讨了脐膨出这一常见先天性腹壁缺陷的胚胎学、危险因素、治疗、检查及并发症。几乎没有证据表明环境因素会导致脐膨出的发生。然而,有大量证据表明遗传或家族危险因素的重要性。产前诊断的新生儿和婴儿是小儿外科医生最常接诊的脐膨出患者。本文描述了处理每种情况的问题和管理步骤,以及任何进一步的并发症。在许多研究论文中,脐膨出和腹裂经常被一起描述。然而,必须认识到它们是两种不同的病症,在解剖结构、病理及相关情况方面存在差异,这导致了它们治疗方法的不同以及明显不同的预后。此外,有证据表明每种病症都有不同的一组与发病风险相关的因素。目前尚不清楚导致这些异常发生的病因。婴儿的大小、病变程度以及任何其他疾病都会影响这些先天性腹壁异常患者的治疗方式。

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Cureus. 2023 Oct 25;15(10):e47638. doi: 10.7759/cureus.47638. eCollection 2023 Oct.
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[Clinical analysis of congenital abdominal wall defects--omphalocele and gastroschisis].先天性腹壁缺损——脐膨出与腹裂的临床分析
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Long-term hospital admissions and surgical treatment of children with congenital abdominal wall defects: a population-based study.先天性腹壁缺陷儿童的长期住院治疗和手术治疗:一项基于人群的研究。
Eur J Pediatr. 2021 Jul;180(7):2193-2198. doi: 10.1007/s00431-021-04005-2. Epub 2021 Mar 5.
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[Umbilicus in children].[儿童的脐部]
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引用本文的文献

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Omphalocele and Associated Anomalies: Exploring Pulmonary Development and Genetic Correlations-A Literature Review.脐膨出及相关异常:探索肺发育与遗传相关性——文献综述
Diagnostics (Basel). 2025 Mar 10;15(6):675. doi: 10.3390/diagnostics15060675.

本文引用的文献

1
Abdominal Wall Defects-Current Treatments.腹壁缺损——当前的治疗方法
Children (Basel). 2021 Feb 23;8(2):170. doi: 10.3390/children8020170.
2
Omphalocele-What should we tell the prospective parents?脐膨出——我们应该告诉准父母什么?
Prenat Diagn. 2021 Mar;41(4):486-496. doi: 10.1002/pd.5886. Epub 2021 Feb 4.
3
Gastroschisis: A State-of-the-Art Review.腹裂:最新综述
Children (Basel). 2020 Dec 17;7(12):302. doi: 10.3390/children7120302.
4
Prenatal diagnosis and management of omphalocele.脐膨出的产前诊断与处理
Semin Pediatr Surg. 2019 Apr;28(2):84-88. doi: 10.1053/j.sempedsurg.2019.04.007. Epub 2019 Apr 6.
5
Long term complications and outcomes in omphalocele.脐膨出的长期并发症及预后
Semin Pediatr Surg. 2019 Apr;28(2):118-121. doi: 10.1053/j.sempedsurg.2019.04.004. Epub 2019 Apr 6.
6
Respiratory disorders in patients with omphalocele.脐膨出患者的呼吸系统疾病
Semin Pediatr Surg. 2019 Apr;28(2):115-117. doi: 10.1053/j.sempedsurg.2019.04.008. Epub 2019 Apr 10.
7
Can cell-free DNA testing be used in pregnancies with isolated fetal omphalocele? Preliminary evidence from cytogenetic results of prenatal cases.游离胎儿 DNA 检测可否用于单纯性胎儿脐膨出的妊娠?产前病例细胞遗传学结果的初步证据。
J Matern Fetal Neonatal Med. 2021 Feb;34(4):624-628. doi: 10.1080/14767058.2019.1611769. Epub 2019 May 6.
8
Outcomes in omphalocele correlate with size of defect.脐膨出的结局与缺损的大小相关。
J Pediatr Surg. 2019 Aug;54(8):1546-1550. doi: 10.1016/j.jpedsurg.2018.10.047. Epub 2018 Oct 22.
9
Early surgical management for giant omphalocele: Results and prognostic factors.巨大脐膨出的早期手术治疗:结果与预后因素
J Pediatr Surg. 2018 Oct;53(10):1908-1913. doi: 10.1016/j.jpedsurg.2018.04.036. Epub 2018 May 24.
10
Accuracy and impact of prenatal diagnosis in infants with omphalocele.脐膨出婴儿产前诊断的准确性和影响
Pediatr Surg Int. 2018 Jun;34(6):629-633. doi: 10.1007/s00383-018-4265-x. Epub 2018 Apr 10.