MEDICAL CARE OF NEWBORNS WITH MECONIUM ILEUS. DATA ANALYSIS OF WORLD EXPERIENCE AND OWN OBSERVATIONS

O. Gorbatyuk, T. Martyniuk
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Abstract

According to various scientists, 10-20 percent of newborns with cystic fi brosis have meconium ileus (MI).MI is an obstruction of the small intestine that occurs in fetuses during the 20th-24th week of gestation due to a violation of the processes of the formation of meconium. The latter has an increased viscosity and cannot pass through the intestines causing their obturation. About 50 percent of the cases of MI are complicated by intestinal volvulus, intestinal atresia, malrotation, perforation with the development of meconium peritonitis and ascites, the formation of a meconium pseudocyst etc. The goal of the research is to conduct a systematic overview of the literature on the issue of MI in neonatal patients and to off er optimal tactics of medical support of newborns with MI on the basis of the analysis of relevant literary sources and our own observations related to this topic.The results. The overview of the literature in the historical aspect covering the last 20 years has demonstrated the following: due to the development and improvement of the methods of conservative surgical treatment of newborns with MI the mortality of the newborns with MI has decreased. The analysis of the data based on the global experience as well as on our own observations indicates the possibility of conservative therapy and surgical treatment of infants with MI and testifi es to the fact that in 50 percent of cases of uncomplicated MI the conservative treatment can be an eff ective option.The research contains the description of the step-by-step measures of conservative treatment. The indications for surgical interventions have also been specifi ed in the research.Conclusion. In treatment of newborns with MI resections and stomata should be avoided. Instead, preference should be given to gastric lavage.
新生儿胎粪回流的医疗护理。世界经验和自身观察的数据分析
根据不同科学家的研究,10%-20% 的囊性纤维化新生儿患有胎粪回肠症(MI)。胎粪回肠症是一种小肠梗阻,发生在妊娠第 20-24 周的胎儿身上,原因是胎粪的形成过程受到破坏。胎粪粘度增加,无法通过肠道,导致肠道闭塞。约 50%的胎粪瘘病例会并发肠套叠、肠闭锁、肠旋转不良、穿孔并引发胎粪腹膜炎和腹水、形成胎粪假性囊肿等。本研究的目的是对有关新生儿脐带绕颈的文献进行系统综述,并在对相关文献资料进行分析的基础上,结合我们自己对这一主题的观察,总结出新生儿脐带绕颈的最佳医疗支持策略。对过去 20 年历史文献的综述表明:由于新生儿心肌缺血保守手术治疗方法的发展和改进,新生儿心肌缺血的死亡率有所下降。基于全球经验和我们自身观察的数据分析表明,对患有心肌缺血的新生儿进行保守治疗和手术治疗是可行的,并证明在 50% 的无并发症心肌缺血病例中,保守治疗是一种有效的选择。研究还具体说明了手术干预的适应症。在治疗患有心肌缺血的新生儿时,应避免切除血管和气孔。相反,应优先考虑洗胃。
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