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在薄如蝉翼的肠道上动刀

2017-08-09 06:37:44   中国青年网

本报讯(记者黄莹 通讯员高琛琛)宝宝刚出生,肠子就破了几个洞,急需手术。早产小婴儿的肠子像蜻蜓翅膀一样薄,医生凌晨冒险手术,切掉20厘米的坏死肠道,孩子得救。

7月10日下午,32周的男婴晗晗在武昌一家医院出生了,体重仅两公斤。家人给晗晗喂了牛奶,不久发现,孩子腹胀、哭闹。第二天晚上,晗晗被转到武汉儿童医院。

新生儿外科医生桂琳玲检查发现,晗晗是坏死性小肠结肠炎,已出现肠穿孔,情况危急。她没有多想,决定立即手术。凌晨2点,历时一个半小时的手术终于顺利完成。

“晗晗是早产,没有发育完全,肠道薄得像蜻蜓的翅膀,轻轻一夹就容易弄伤,因此手术每一步都得万分小心。”新生儿外科主任余雷介绍,晗晗肠道的坏死部分,分布在三个不同位置,医生必须仔细鉴别,“精打细算”地切掉了20厘米的坏肠。

其实,像晗晗这么小的宝宝,一般来说分两期手术是最安全的。先做肠造瘘,等孩子两三个月情况更稳定时,再做肠道吻合。像这次这样“一步到位”,对医生的技术要求很高,手术风险也更大。

余雷说,如果只做一期手术,孩子吃了奶很快就会漏出来,无法吸收营养,只能长期通过静脉输送营养。这样一来,家长不方便护理孩子,宝宝生长发育受影响。经过讨论,专家们冒险选取直接吻合手术。孩子也很争气,术后至今20多天,都没有出现并发症。

8日,记者在新生儿科病房内看到,晗晗在妈妈怀里吸着奶瓶,小腿乱蹬,恢复得不错。医生表示,晗晗很快就可以出院,将来生长发育与一般孩子比,不会有太大差异。据了解,即使在儿童医院,给仅32周胎龄的宝宝做肠道手术,也属罕见。

余雷提醒,新生儿坏死性小肠结肠炎主要在早产儿或患病的新生儿中发生,如果发现新生宝宝腹胀、便血、哭闹,家长要提高警惕。母乳能建立宝宝肠道中益生菌菌群,促进宝宝肠道健康发育,所以尽可能母乳喂养。

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