婴儿腹壁缺陷。生存情况及对成年生活的影响。
Abdominal wall defects in infants. Survival and implications for adult life.
作者信息
Tunell W P, Puffinbarger N K, Tuggle D W, Taylor D V, Mantor P C
机构信息
Department of Surgery, University of Oklahoma College of Medicine/Children's Hospital of Oklahoma, Oklahoma City, USA.
出版信息
Ann Surg. 1995 May;221(5):525-8; discussion 528-30. doi: 10.1097/00000658-199505000-00010.
OBJECTIVE
The authors study reviewed patients who underwent operations for omphalocele and gastroschisis to determine survival, morbidity, and long-term quality of life.
METHOD
Clinical follow-up of 94 patients cared for with omphalocele and gastroschisis during a 10- to 20-year period after birth.
RESULT
Eighty-three patients survived initial treatment. Sixty-one had long-term follow-up. Mean follow-up in the group was 14.2 years. Survival was favorable in the absence of lethal or co-existing major congenital anomalies. Nineteen patients required 31 reoperations, most for abdominal wall hernias and the sequelae of intestinal atresia. Current quality of life was described as favorable (good) in 80% of patients.
CONCLUSIONS
Survival rate in patients with abdominal wall defects is favorable and deaths occur substantially in patients with co-existing lethal, or multiple, congenital anomalies. Reoperative surgery is necessary principally in those patients who have postclosure abdominal wall hernias, and in those with bowel atresia at birth. Reoperations are not likely to be necessary after school age. Quality of life in survivors is patient-perceived as entirely satisfactory.
目的
作者回顾性研究了接受脐膨出和腹裂修补手术的患者，以确定其生存率、发病率和长期生活质量。
方法
对94例出生后10至20年间接受脐膨出和腹裂治疗的患者进行临床随访。
结果
83例患者经初始治疗后存活。61例进行了长期随访。该组患者的平均随访时间为14.2年。在没有致命或并存的主要先天性异常的情况下，生存率良好。19例患者需要进行31次再次手术，大多数是因为腹壁疝和肠闭锁后遗症。80%的患者目前的生活质量被描述为良好。
结论
腹壁缺损患者的生存率良好，死亡主要发生在伴有致命或多种先天性异常的患者中。再次手术主要适用于那些术后出现腹壁疝的患者以及出生时患有肠闭锁的患者。学龄期后不太可能需要再次手术。患者认为幸存者的生活质量完全令人满意。
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