出汗:当胎便性肠梗阻不是囊性纤维化时——一例报告。

IF 0.6 Q4 NURSING
Mary Beth Whalen, Tiffany Gwartney
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引用次数: 0

摘要

肠便性肠梗阻(MI)是由于粘稠、干燥、密集的肠便积聚造成肠阻塞的结果,最常见于回肠末端。这些粪袋阻止大便通过阻塞点,从而导致肠近端膨胀,肠壁增厚和远端微结肠。最常见的是(90%)合并囊性纤维化(CF),没有CF的心肌梗死的发生是罕见的。文献描述,在最常见的CF基因突变Delta F508对(纯合子)患者中,心肌梗死与CF相关的发生率高达24.9%。心肌梗死的发生率随着其他CF突变而降低,其中有超过2000种。发病率和死亡率风险与心肌梗死是简单的还是复杂的有关。临床上,单纯性心肌梗死可通过造影剂灌肠来缓解梗阻,恢复肠功能,而复杂性心肌梗死则需要手术治疗,因为在子宫内或出生后可能发生肠坏死、穿孔、腹膜炎、狭窄和/或肠扭转。本文报告一例孕32周的女婴在出生后第1天出现腹胀。鉴别诊断,必要的检查,以及导致最终诊断所需的治疗将被提出。此外,本文还讨论了用于确认诊断的放射学模式。最后,将讨论简单或复杂心肌梗死婴儿的护理管理以及婴儿及其家庭面临的短期和长期挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sweating It Out: When Meconium Ileus Is Not Cystic Fibrosis-A Case Report.

Meconium ileus (MI) is the result of the accumulation of thick, dry, inspissated meconium that creates a bowel blockage, most commonly in the terminal ileum. These pockets of meconium prevent passage of stool beyond the point of obstruction, which leads to distention of the proximal bowel, bowel wall thickening, and distal microcolon. Occurring most commonly (90%) in conjunction with cystic fibrosis (CF), the occurrence of MI without CF is rare. The literature describes the incidence of MI associated with CF occurring in as many as 24.9% of those who have a pair (homozygous) of the most common CF gene mutation, Delta F508. The incidence of MI decreases with other CF mutations, of which there are over 2,000. The morbidity and mortality risks are related to whether the MI is simple or complex. Simple MI can be managed clinically with contrast enemas to relieve the obstruction and restore bowel function, while complex MI requires surgical intervention for possible bowel necrosis, perforation, peritonitis, strictures, and/or volvulus that can occur in utero or after birth. This article presents a case report of a 32-week-gestation female infant with gross abdominal distention beginning on day of life 1. The differential diagnosis, necessary testing, and required treatment that led to the final diagnosis will be presented. Additionally, radiographic modalities used to confirm the diagnosis are discussed. Finally, nursing management of the infant with simple or complex MI and short- and long-term challenges for infants and their families will be addressed.

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来源期刊
Neonatal Network
Neonatal Network NURSING-
CiteScore
0.90
自引率
14.30%
发文量
87
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