Gastroschisis and omphalocele
Gastroschisis and omphalocele
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DOI：
10.1016/j.suc.2005.12.003
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发表时间：
2006-04-01
影响因子：
3.1
通讯作者：
Ledbetter, DJ
中科院分区：
文献类型：
--
作者：
Ledbetter, DJ
不同的胚胎学，流行病学，相关的异常，腹裂和脐膨出的自然历史进行了审查。我们讨论了治疗原则，并推荐了具体的手术策略：对于腹裂，早期床边放置预制的弹簧加载硅橡胶筒仓，随后通过延迟一期修复或正式筒仓放置和分期复位的方式关闭腹壁;对于脐膨出，局部用磺胺嘧啶银治疗后，对小缺损进行一期修复，对较大缺损进行延迟修复。在这两种情况下，死亡率和发病率的主要决定因素通常不是腹壁缺损：对于腹裂，它主要与相关的肠道损伤程度有关;对于脐膨出，它主要与经常发生的严重相关异常有关。
The distinct embryology, epidemiology, associated anomalies, and natural history of gastroschisis and omphalocele are reviewed. Principles of management are discussed and specific surgical strategies are recommended: for gastroschisis, early bedside placement of a prefabricated, spring-loaded Silastic silo and later abdominal wall closure by way of delayed primary repair or formal silo placement and staged reduction; for omphalocele, primary repair of small defects and delayed repair of larger defects after topical treatment with silver sulfadiazine. In both cases, the main determinant of mortality and morbidity is usually not the abdominal wall defect: for gastroschisis, it is mainly related to the degree of associated intestinal injury; for omphalocele, it is mainly related to the frequently occurring serious associated anomalies.