Chappuis J P, Takvorian P, Philibert M, Dodat H, Salle B
Pediatrie. 1984 Sep;39(6):437-44.
Study about 22 gastroschisis observed 17 years along allows to the authors to point out the elements of amelioration of prognostic and decrease of mortality. Antenatal diagnosis allows the hysterotomy at the end of gestation avoiding traumatic or infectious risks. Reanimation and transport are very important to bring the neonate in good conditions to the pediatric surgeon. The choice of surgical technics is only between primitive parietal closure or progressive reintegration (Schuster). Intestinal atresia must be cured in the same time, if possible. Finally, perisurgical nursing, antibiotherapy and recent parenteral nutrition method improved the prognosis. During the last 15 years, mortality has fallen from 80% to 10%.
对22例腹裂患儿长达17年的研究使作者能够指出改善预后及降低死亡率的因素。产前诊断可在妊娠末期进行剖宫产,避免创伤或感染风险。复苏和转运对于使新生儿以良好状态送至小儿外科医生处非常重要。手术技术的选择仅在原始的腹壁关闭术或渐进性再整合术(舒斯特术)之间。如有可能,必须同时治疗肠道闭锁。最后,围手术期护理、抗生素治疗及近期的肠外营养方法改善了预后。在过去15年中,死亡率已从80%降至10%。