摘要目的:分析先天性肠闭锁的病理组织学改变及其对肠道功能的影响,以探讨肠闭锁手术的切除范围.方法:对16例先天性肠闭锁手术切除之远近端肠管行HE染色,光镜下观察肠壁各层厚度及神经组织的改变及其范围.结果:在各型肠闭锁中,远近端肠管除肠壁厚度有改变外,各层神经丛及神经节细胞数均较正常明显减少,近端改变范围大于10 cm,远端改变局限于2cm内.在此范围内,随着远离闭锁盲端,上述指标均有逐渐增加的趋势.结论:本组结果从病理角度上对肠闭锁手术切除范围提供了理论依据,并对术后肠道功能恢复缓慢的现象给予解释.提出肠闭锁术后应依据具体情况合理延长TPN时间,以期患儿安全度过肠道功能自我逆转期.

abstractsObjective:To study pathohistological changes in congenital intestinal atresia as the reference of surigical resection.Methods:Sixteen cases of congenital intestinal atresia were studied.The specimens were taken from the resected intestinal segments proximal and distal to the atresia.The sections were stained with haematoxylin and eosin,and examined under light microscope.Results:The submucosal plexus,myenteric plexus and ganglionic cells decreased in number at both ends of the atresia on the thickened intestinal wall.These changes extended 10 cm proximally and 2 cm distally from the blind end,and showed a tendency on the increase at the farther and of atresia.Conclusions:The above mentioned changes explain the postoperative intestinal disorders.The extent of intestinal resection is suggested.Total parenteral nutrition must be provided for the recovery of the effective intestinal function with a period of time after operation.