PDF(Pubmed)
Abstract：
BACKGROUND: Exomphalos anomaly is defined as the herniation of abdominal viscera into the base of the umbilical cord, with only a membranous sac covering these contents. It has an incidence of approximately 1 in 4000-6000 births. Management of exomphalos major (EM) remains controversial and limited, with very few studies to guide decision-making.
METHODS: This is a case series of four neonates with EM treated at a tertiary paediatric referral centre between 2018 and 2021 with a gradual compression dressing technique.
RESULTS: Four neonates were diagnosed with EM. The average gestational age was 38 + 5 (range 38 + 2 - 39 + 2), and the average birth weight was 3.1 kg (range 2.56 - 3.49 kg). The defect size ranged between 5 and 7 cm. All patients were commenced on gradual compression dressing between days 1 and 3 of life. Dressings were applied at the bedside in the general neonatal ward. The average time taken to reach full feeds was 1 week; only one patient required parenteral nutrition. Three underwent surgical repair at two and 16 weeks of age; one had delayed repair at the age of 1 year because of the COVID-19 pandemic. None required patch repair. None required prolonged ventilation after repair.
CONCLUSIONS: This case series describes a successful compression dressing technique that reduces sac content without the need for general anaesthetic or respiratory compromise, whereby simultaneous enteral feeding is tolerated.
METHODS: This is a case series of four neonates with EM treated at a tertiary paediatric referral centre between 2018 and 2021 with a gradual compression dressing technique.
RESULTS: Four neonates were diagnosed with EM. The average gestational age was 38 + 5 (range 38 + 2 - 39 + 2), and the average birth weight was 3.1 kg (range 2.56 - 3.49 kg). The defect size ranged between 5 and 7 cm. All patients were commenced on gradual compression dressing between days 1 and 3 of life. Dressings were applied at the bedside in the general neonatal ward. The average time taken to reach full feeds was 1 week; only one patient required parenteral nutrition. Three underwent surgical repair at two and 16 weeks of age; one had delayed repair at the age of 1 year because of the COVID-19 pandemic. None required patch repair. None required prolonged ventilation after repair.
CONCLUSIONS: This case series describes a successful compression dressing technique that reduces sac content without the need for general anaesthetic or respiratory compromise, whereby simultaneous enteral feeding is tolerated.
摘要：
背景：exomphalos异常定义为腹部内脏突出到脐带底部，只有一个膜状囊覆盖着这些内容物。它的发病率约为4000-6000例新生儿中的1例。exomphalosmajor(EM)的管理仍然存在争议和限制，很少有研究来指导决策。
方法：这是一个病例系列，其中包括2018年至2021年在三级儿科转诊中心接受逐步加压包扎技术治疗的四名EM新生儿。
结果：4例新生儿被诊断为EM。平均胎龄为38+5（范围38+2-39+2），平均出生体重为3.1kg（范围为2.56-3.49kg）。缺损尺寸在5至7cm之间。所有患者在生命的第1天和第3天之间开始使用逐渐加压敷料。在一般新生儿病房的床边使用敷料。达到完全进食所需的平均时间为1周；只有一名患者需要肠胃外营养。三人在2周龄和16周龄时接受了手术修复；一人在1岁时因COVID-19大流行而推迟了修复。没有需要修补程序修复。修复后不需要长时间通风。
结论：本病例系列描述了一种成功的压缩敷料技术，该技术可在不需要全身麻醉或呼吸损害的情况下减少囊含量，因此，同时肠内喂养是可以容忍的。
方法：这是一个病例系列，其中包括2018年至2021年在三级儿科转诊中心接受逐步加压包扎技术治疗的四名EM新生儿。
结果：4例新生儿被诊断为EM。平均胎龄为38+5（范围38+2-39+2），平均出生体重为3.1kg（范围为2.56-3.49kg）。缺损尺寸在5至7cm之间。所有患者在生命的第1天和第3天之间开始使用逐渐加压敷料。在一般新生儿病房的床边使用敷料。达到完全进食所需的平均时间为1周；只有一名患者需要肠胃外营养。三人在2周龄和16周龄时接受了手术修复；一人在1岁时因COVID-19大流行而推迟了修复。没有需要修补程序修复。修复后不需要长时间通风。
结论：本病例系列描述了一种成功的压缩敷料技术，该技术可在不需要全身麻醉或呼吸损害的情况下减少囊含量，因此，同时肠内喂养是可以容忍的。
