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十二指肠闭锁及修复(儿科)

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ID: ANH13089chis
"医学动画文字记录:十二指肠闭锁是一种先天缺陷,是指婴儿小肠的起始部分,即十二指肠阻塞。小肠位于胃和大肠之间,从食物中吸收营养。小肠分为三部分:十二指肠、空肠和回肠。十二指肠在怀孕第6周形成。这时可以看到将来发育为消化系统的管道。十二指肠位于发育中的胃的下面。十二指肠内的细胞生长得非常快,以至于管腔会阻塞一段时间。随后,作为正常发育的一部分,阻塞十二指肠内部的细胞死亡,直到发育中的肠道重新开放。 在怀孕10周左右,由于未知的原因,十二指肠外壁可能生长不正常。此外,阻塞十二指肠内部的细胞可能还没有死亡。其结果会导致发生十二指肠闭锁的缺陷,其中一部分十二指肠被一种或多种方式阻塞。它可能被网状组织内膜阻塞,也可能有一部分十二指肠完全缺失。最后,十二指肠可能变窄。因为液体不能通过十二指肠,任何一种类型的闭锁都会妨碍婴儿从乳汁中吸收营养。十二指肠闭锁不会立即危及生命。但需要在出生后几天内进行手术来修复阻塞的十二指肠。手术前,需要在婴儿出生后不久通过鼻子或口腔插入一根吸管(NG),将多余的液体和空气从胃中排出。在整个手术过程中,进行全身麻醉,使婴儿处于睡眠状态。在手术过程中,经鼻腔或口腔进行气管插管,以帮助婴儿呼吸。通常,医生会在右侧肋骨下做一个切口。接下来,医生会仔细地找到婴儿十二指肠的闭锁处或狭窄阻塞的部分。在闭锁上方和下方将十二指肠切开。用缝线将两个开口吻合,从而绕过闭锁。最后,用可溶解缝线或皮肤闭合条缝合皮肤切口。术后患儿将被送往新生儿重症监护病房进行监护。医生会给婴儿使用止痛药。可能会继续给婴儿静脉注射抗生素。消化系统正常运作2~4周内可以出院。"

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