摘要目的 通过治疗1例横结肠隔膜患儿并通过文献复习,探讨有效的治疗方案.方法 回顾性分析1例横结肠隔膜手术患儿的临床资料.并通过检索中国知网(CNKI)、万方、维普数据库、Pubmed、Ringer Link、Google Scholar等数据库和检索平台,总结儿童结肠闭锁的临床特点及诊治经验.结果 本例在横结肠隔膜处(结肠脾曲近端约5 cm)行肠切除肠吻合,术后恢复良好,病理证实为横结肠隔膜,术后随访半年饮食、排便等各项指标均正常.共检索到符合纳入标准的患儿98例,1期手术25例,2期手术48例,多期手术25例,其中1期手术的25例,均术后恢复顺利;3例2期手术患儿因术后出现巨结肠,需再次手术,家长由于经济原因放弃;5例2期手术患儿,因术后出现重症感染,导致多器官功能衰竭而死亡;1例2期手术患儿失访;多期手术患儿25例,其中1例因合并5处小肠闭锁,术后患儿严重营养不良,家长放弃治疗.术后随访6个月至2年,患儿均营养状态良好,吸收无障碍.结论 儿童结肠闭锁临床症状各异,术前诊断困难,钡灌肠检查是有效的诊断手段.目前,有效的治疗方法是手术切除,根据结肠闭锁类型及是否合并多发畸形决定具体的手术方式.

abstractsObjective To improve the understanding of colonic atresia in children and explore effective treatments through one case report of transverse colon diaphragm and literature review . Methods Retrospective analysis was performed for 1 surgical case of transverse colonic septum .And the clinical characteristics ,diagnosis and treatment of colonic atresia were reviewed by retrieving the relevant Chinese and English literature reports from the databases of China National Knowledge Infrastructure (CNKI) ,Wanfang ,Weipu ,Pubmed ,Ringer Link and Google Scholar .Results In this case ,transverse diaphragm was located at around 5 cm away from proximal splenic flexure . After intestinal resection and anastomosis ,the child recovered well .Transverse diaphragm was confirmed by pathological examination .During a 6-month follow-up ,the parameters of diet and defecation returned to normal .A total of 98 cases fulfilling the inclusion criteria were retrieved .The operative stages were Ⅰ (n= 25) , Ⅱ (n= 48) and multiple (n= 25) .All cases recovered well after operations .Three cases of stage Ⅱ required re-operation due to Hirschsprung's disease .However ,their parents gave up due to economic reasons .Five cases of stage Ⅱ developed severe infection and died from multiple organ failure .One case of stage Ⅱ was lost to follow-up .Among 25 cases of multiple surgeries ,one case with five sites of small intestinal atresia became severely malnourished and the parents gave up treatment .During a follow-up period of 6-24 months ,all children were well-nourished without any absorptive disturbance .Conclusions The clinical symptoms of colonic atresia vary greatly and preoperative diagnosis is rather difficult . Barium enema is an effective diagnostic tool . Currently effective treatment is surgical resection ,depending on the types of colonic atresia and the combinations of multiple deformities .