PDF(Pubmed)
Abstract：
UNASSIGNED: Gastroschisis has increased in recent years, however, complicated gastroschisis is associated with higher mortality, as well as higher health care costs and disease burdens from short- and long-term complications.
UNASSIGNED: A woman aged 25 years old at 37 + 1 weeks gestation (gravida 2; para 0) was admitted to the hospital because of foetal gastroschisis. Targeted quaternary ultrasound performed at our hospital showed that 34 mm of the abdominal wall was interrupted continuously, an intestinal echo with a range of approximately 88 × 50 mm was seen bulging outwards the local area close to the intestinal wall showed a 34 × 23 m anecho, and the foetus was measuring 2 weeks smaller than expected. After MDT including the maternal-foetal medicine, ultrasound, paediatric surgery, neonatal intensive care unit (NICU), and anaesthesiology departments, caesarean section was performed at 37 + 2 weeks. A baby boy was delivered, the small intestine, large intestine and stomach were seen outside of the abdomen, the abdominal cavity was excluded from the defect on the right side of the umbilical cord, the mesentery was shortened, and the intestinal tube had obvious oedema After paediatric surgical discussion, silo bag placement and delayed closure was performed, the placement process was smooth. One week following silo placement, the abdominal contents had been fully reduced below the fascia following daily partial reductions of the viscera,and the second stage of the operation was performed under general anaesthesia. The newborn was successfully discharged from the hospital 20 days after the operation and was followed up, with good growth, normal milk intake and smooth bowel movements.
UNASSIGNED: The diagnosis and treatment of complicated gastroschisis needs to be carried out under multidisciplinary team treatment. Delivery by cesarean section after 37 weeks is feasible.Immediate postpartum surgery is possible, and the choice of surgical modality is determined by the child\'s condition, emphasizing that it should be performed without adequate sedation under anaesthesia. A standardized postoperative care pathway appropriate to risk should be developed to optimize nutritional support and antibiotic use, and standardized enteral feeding practices should be sought with long-term follow-up.
UNASSIGNED: A woman aged 25 years old at 37 + 1 weeks gestation (gravida 2; para 0) was admitted to the hospital because of foetal gastroschisis. Targeted quaternary ultrasound performed at our hospital showed that 34 mm of the abdominal wall was interrupted continuously, an intestinal echo with a range of approximately 88 × 50 mm was seen bulging outwards the local area close to the intestinal wall showed a 34 × 23 m anecho, and the foetus was measuring 2 weeks smaller than expected. After MDT including the maternal-foetal medicine, ultrasound, paediatric surgery, neonatal intensive care unit (NICU), and anaesthesiology departments, caesarean section was performed at 37 + 2 weeks. A baby boy was delivered, the small intestine, large intestine and stomach were seen outside of the abdomen, the abdominal cavity was excluded from the defect on the right side of the umbilical cord, the mesentery was shortened, and the intestinal tube had obvious oedema After paediatric surgical discussion, silo bag placement and delayed closure was performed, the placement process was smooth. One week following silo placement, the abdominal contents had been fully reduced below the fascia following daily partial reductions of the viscera,and the second stage of the operation was performed under general anaesthesia. The newborn was successfully discharged from the hospital 20 days after the operation and was followed up, with good growth, normal milk intake and smooth bowel movements.
UNASSIGNED: The diagnosis and treatment of complicated gastroschisis needs to be carried out under multidisciplinary team treatment. Delivery by cesarean section after 37 weeks is feasible.Immediate postpartum surgery is possible, and the choice of surgical modality is determined by the child\'s condition, emphasizing that it should be performed without adequate sedation under anaesthesia. A standardized postoperative care pathway appropriate to risk should be developed to optimize nutritional support and antibiotic use, and standardized enteral feeding practices should be sought with long-term follow-up.
摘要：
■近年来，胃裂病有所增加，然而,复杂的腹裂与较高的死亡率有关，以及短期和长期并发症导致的更高的医疗保健成本和疾病负担。
■一名25岁的女性在妊娠37+1周（第2次妊娠；第0次妊娠）时，因胎儿胃裂入院。在我院进行的靶向四元超声检查显示，腹壁连续中断34mm，观察到范围约为88×50毫米的肠回声向外凸出，靠近肠壁的局部区域显示出34×23米的回声，胎儿比预期小2周。在包括母婴医学在内的MDT之后，超声，儿科手术,新生儿重症监护病房(NICU),和麻醉科，剖腹产在37+2周。生了一个男婴,小肠，腹部外可见大肠和胃，从脐带右侧的缺损中排除了腹腔，肠系膜缩短了,经儿科手术讨论，肠管有明显的水肿，进行筒仓袋放置和延迟关闭，放置过程很顺利。竖井放置一周后，每天内脏部分减少后，腹部内容物已经完全减少到筋膜以下，第二阶段的手术是在全身麻醉下进行的。新生儿在手术后20天顺利出院,并进行了随访,随着良好的增长，正常的牛奶摄入量和平稳的排便。
■复杂胃裂的诊断和治疗需要在多学科小组治疗下进行。37周后剖宫产分娩是可行的。立即进行产后手术是可能的，手术方式的选择取决于孩子的病情，强调在麻醉下应在没有足够镇静的情况下进行。应制定适合风险的标准化术后护理路径，以优化营养支持和抗生素使用。应寻求长期随访的标准化肠内喂养方法。
■一名25岁的女性在妊娠37+1周（第2次妊娠；第0次妊娠）时，因胎儿胃裂入院。在我院进行的靶向四元超声检查显示，腹壁连续中断34mm，观察到范围约为88×50毫米的肠回声向外凸出，靠近肠壁的局部区域显示出34×23米的回声，胎儿比预期小2周。在包括母婴医学在内的MDT之后，超声，儿科手术,新生儿重症监护病房(NICU),和麻醉科，剖腹产在37+2周。生了一个男婴,小肠，腹部外可见大肠和胃，从脐带右侧的缺损中排除了腹腔，肠系膜缩短了,经儿科手术讨论，肠管有明显的水肿，进行筒仓袋放置和延迟关闭，放置过程很顺利。竖井放置一周后，每天内脏部分减少后，腹部内容物已经完全减少到筋膜以下，第二阶段的手术是在全身麻醉下进行的。新生儿在手术后20天顺利出院,并进行了随访,随着良好的增长，正常的牛奶摄入量和平稳的排便。
■复杂胃裂的诊断和治疗需要在多学科小组治疗下进行。37周后剖宫产分娩是可行的。立即进行产后手术是可能的，手术方式的选择取决于孩子的病情，强调在麻醉下应在没有足够镇静的情况下进行。应制定适合风险的标准化术后护理路径，以优化营养支持和抗生素使用。应寻求长期随访的标准化肠内喂养方法。
