頁籤選單縮合
題 名 | 嬰兒肥厚性幽門狹窄 |
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作 者 | 陳肇隆; 林哲男 ; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 14:1 1981.03[民70.03] |
頁 次 | 頁51-57 |
關鍵詞 | 嬰兒肥厚性幽門狹窄; |
語 文 | 中文(Chinese) |
中文摘要 | 長庚紀念醫院小兒外科三年來共經歷了13例嬰兒肥厚性曲門狹窄,13例都做了Ramstedt幽門肌肉切開術,結果有一例術後發生傷口裂開,其餘病例病程順利,沒有其他合併症,也沒有死亡病例。根據我們的經驗下列幾點與治療成績的進步有關:(1)對於開刀前水份和電解質平衡的了解與重視,(2)採用橫向皮膚切開以利傷口癒合,(3)採用Benson氏幽門擴張器,使幽門的環狀肌肉更有效而安全地完全分離,(4)開刀後隔日餵食,慢慢少量增加,以減少術後嘔吐的發生。 |
英文摘要 | Infantile hypertrophic pyloric stenosis is an abnormality of the pyloric musculature causing gastric outlet obstruction in infancy. It was previously referred to as congenital hypertrophic pyloric stenosis which misled inasmuch as symptoms as well as the demonstrable pathological changes of pyloric stenosis are almost never present at birth. Projectile vomiting, gastric waves, and apalpable pyloric tumor constitute the diagnostic triad of pyloric stenosis. Vomiting is the initial symptom with average onset at two to three weeks of age which is projectile and free of bile. The presence of peristaltic waves is not diagnostic of pyloric stenosis because they can be seen in other conditions, such as severe pylorospasm. Palpation of an olive-shaped, firm muscular mass, the pathognomonic finding of pyloric stenosis, is successful in 85% of our patients. Barium meal examination is helpful in diagnosis only when a tumor cannot be palpated. Ramstedt pyloromvotomy is now universally accepted as a safe and efficient treatment of infantile hypertrophic pyloric stenosis. Preoperative preparation to restore fluid and electrolyte imbalance was usually accomplished after overnight hydration in our cases. We preferred a transverse skin incision followed by vertical splitting of the right rectus muscle for better wound healing in a debilitate infant. The use of the Benson's pyloric spreader enabled us to separate effectively the circular muscle of the pylorus with minimal bleeding and less side injuries. The gastric tube was removed as soon as the infant recovered from anethesia and the oral feedings were started the next early morning after surgery in small increment to minimize postoperative vomiting. 13 cases of infantile hypertrophic pyloric stenosis so treated at the Chang Gung Memorial Hospital during a threeyear period from 1977 to 1980 bore no mortality and minimal morbidity. |
本系統中英文摘要資訊取自各篇刊載內容。