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1、小儿肠系膜裂孔疝临床病例特点分析摘要：目的：结合临床病例，对小儿先天性肠系膜裂孔疝的临床病例特点进行分析。方法：回顾性分析我院外科2007年2月—2014年2月间住院治疗，并经手术证实为肠系膜裂孔疝者29例，对上述病例的临床资料进行分析探讨。结果：入院时患儿的临床表现：呕吐26例，腹痛22例，腹胀11例，停止排气排便7例，血便2例；伴休克前期或休克者4例,伴腹膜炎者3例；行腹腔穿刺为血性腹水者9例。术前即高度怀疑肠系膜裂孔疝或腹内疝10例；术前诊断机械性肠梗阻11例；术前不明确诊断4例；术前误诊为其他疾病者4例；其中多发裂孔疝有2例。上述病例中
2、致肠缺血坏死23例，其中19例行肠切除肠吻合术，4例行肠外置术。结论：先天性肠系膜裂孔疝早期诊断困难，极易误诊、漏诊，导致肠缺血坏死，严重者将丢失大量肠管，甚至造成短肠综合征。对于疑似病例，应早期手术探查术中根据肠管缺血情况行肠管复位术,肠切除肠吻合术或肠外置术。关键词：肠系膜裂孔疝；先天性；发病机理；病例特点Abstract：Aim：Bystudyingclinicalcases,theclinicalcharacteristicsofcongenitalmesenterichiatalherniainchildrenincludingpat
3、hogenesis,diagnosisandtreatmentwereanalyzed.Methods：Aretrospectiveanalysiswasconducted.Theclinicaldataof29hospitalizedpatientswithcongenitalmesenterichiatalherniainourhospitalfrom2007Februaryto2014Februarywerestudied.Results:Inallpatients,themajorclinicalsymptomsincludevomit
4、ingin26cases,abdominalpainin22cases,abdominaldistentionin11cases,theabsenceofexhaustanddefecatein7cases,bloodystoolin2cases.Moreover,4casescomplicatedwithhypovolemicshock,3caseswithperitonitis,9caseswithbloodyascitesbyabdominalpuncture.Amongthese29patients,10caseswerehighlys
5、uspectedmesenterichiatalherniapreoperatively,11caseswerediagnosedasintestinalmechanicalobstructionatemergency.Nodefinitivediagnosesweregivenin4cases,whereasother4casesweremisdiagnosedpreoperatively.MultipleMesenterichiatalhappenedin2cases.23casesweredemonstratedintestinalisc
6、hemicnecrosisduringoperation,inwhich19casesimplementedintestinalresectionandanastomosisand4casesdidintestinalexteriorization.Conclusion：Earlydiagnosisofcongenitalmesenterichiatalherniaisdifficult.Delayeddiagnosismightleadtointestinalischemiaandnecrosis,evenresultinginshortbo
7、welsyndrome.Forsuspectedpatients,earlyexploratoryoperationshouldbepreformedtoavoidmassintestinelose.Intestinalreposition,resectionandanastomosisorintestinalexteriorizationwerechosenaccordingtointestinalstatus.Keywords:Mesenterichiatalhernia;Congenital;Pathogenesis;Clinicalch
8、aracteristicsHeuerman[1]在1778年尸检时首先发现并报道了肠系膜裂孔疝。本病在临床中较为少见，约占机械性肠梗阻的1％～2％，是
