ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2015, Vol. 7 ›› Issue (5): 440-443.doi: 10.3969/j.issn.1674-3865.2015.05.011

• 临床研究 • 上一篇    下一篇

先天性肥厚性幽门狭窄死亡原因分析

邹婵娟,李碧香,周崇高,王海阳,许光,夏仁鹏   

  1. 410007 长沙,湖南省儿童医院新生儿外科
  • 出版日期:2015-10-25 发布日期:2015-11-19
  • 作者简介:邹婵娟(1979-),女,医学硕士,主治医师。研究方向：新生儿先天性畸形及早产、危重症儿的围术期治疗,E-mail：xinshengerke2@sina.com。

Analysis of the death cause in congenital hypertrophic pyloric stenosis

ZOU Chanjuan，LI Bixiang，ZHOU Chonggao，WANG Haiyang，XU Guang，XIA Renpeng   

  1. Neonatal Surgery Department，Hunan Provincial Children Hospital，Changsha 410007，China
  • Online:2015-10-25 Published:2015-11-19

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摘要：
目的：分析先天性肥厚性幽门狭窄的死亡原因以提高患儿存活率。
方法：对626例先天性肥厚性幽门狭窄患儿病例进行分析,其中治愈602例,未手术出院20例,死亡4例,治愈率达96.16%。分析死亡病历的临床特点及死亡原因。
结果：4例死亡病例均发生在术后。2例不耐受手术打击出现心肺功能衰竭死亡。1例术后死于高血钾。1例术后手术创面活动性出血,经保守治疗时出现猝死。
结论：先天性肥厚性幽门狭窄主要死亡原因是重症感染、内环境代谢紊乱、术后应激反应、喂养不当,重视预防、积极处理可降低危重病患儿的病死率。术前感染控制、电解质紊乱的纠正、营养的改善以及术中、术后等围手术期仔细、全面的治疗、预防应激反应是患儿顺利恢复的关键。

关键词: 先天性幽门狭窄, 营养不良, 手术, 感染, 死亡, 儿童

Abstract:
Objective：To analyze the data of the death cause in congenital hypertrophic pyloric stenosis in order to improve the survival rate.
Methods：Totally 626 patients diagnosed with HPS were analyzed, 602 cases underwent laparoscopic pyloromyotomy and cured, 20 cases were discharged from hospital without operation, and 4 cases died, the cure rate being 96.16%. For the 4 death cases, we analyzed the clinical characteristics and causes of death.
Results:The 4 deaths occurred after operation：2 cases died after operation because of cardiorespiratory function failure，and 1 case died from hyperkalemia. The surgical wound bleeding occurred in 1 patient after operation, and there was a sudden death in the treatment.
Conclusion:The main causes of death of HPS are severe infection, internal metabolic disorders, stress reaction after operation, and improper feeding. Paying high attention to the prevention and managing actively can reduce the fatality. The key to successful recovery is the control of infection, electrolyte disturbance correction, and improved nutrition in preoperative period, and careful and comprehensive treatment and prevention of stress reaction during and after operation.

Key words: congenital hypertrophic pyloric stenosis, malnutrition, surgery, infection, death, children

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