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心疼!680克早产儿出生5天肠穿孔

2017-09-02 07:45:56   中国青年网

轩轩体重才680克,身量跟成人手掌相当 本报通讯员 劳诚毅 摄

轩轩的脚只有成人拇指大小 本报通讯员 姚瑞兰 摄

在妈妈肚子里待了28周+2天,轩轩(化名)便来到这个世界上,其出生时身体瘦小得跟成人手掌相当。在新生儿科待了5天后,轩轩突发肠穿孔。庆幸的是,他的父母和医生没有放弃。经过一个小时的手术,医生切除了轩轩10厘米的穿孔肠子。术后第二天,轩轩生命体征平稳。

早产新生儿突发肠穿孔

轩轩的妈妈今年31岁,来自湖北的她并非第一次当妈妈。在怀上轩轩后做B超才发现,这一胎是双胞胎。怀孕3个月后,轩轩的妈妈到小区附近一家医院立卡,入院前已经做了6次孕检。

一般来说,双胞胎早产概率比较大。8月25日,轩轩的妈妈羊水突然破了。由于情况危急,轩轩的妈妈立即被转到南宁市妇幼保健院(以下简称市妇幼)。26日上午,只在妈妈肚子里待了28周+2天的轩轩出生了。由于早产等各种原因,另一个宝宝没有保住。轩轩出生后各项指标评分达标,很快就被送到新生儿监护室。

8月31日上午,医护人员发现,轩轩肚子胀得厉害,皮肤几乎被撑成透明的。检查后发现是肠穿孔。该院儿童保健部主任张树英称,出现这种情况如果不立即手术,轩轩可能挺不过当晚,因为肠穿孔后,肠道里的细菌弥漫至腹腔,会引起败血症,导致死亡。“跟家长沟通后,家长希望全力挽救这个孩子。”张树英说,家长对救治轩轩的意愿十分强烈,院方立即召集外科、新生儿科、麻醉科、医务部进行紧急会诊。在制定详细的应对方案后,医生们决定放手一搏。

手术切除了10厘米肠子

手术前,医生给轩轩称了体重,仅有680克。轩轩身体跟成人手掌相当,肠壁的细薄可想而知。手术风险之大,让参与手术的各科医生心里都没底。但既然接受了挑战,就一定要做到最好。

一台高风险的手术,麻醉至关重要。手术麻醉科主任劳诚毅说,轩轩的麻醉药用量仅为成年人的1%,而且药量必须精确,稍有偏差,680克的小身体将无法耐受。

在多个科室的联合保障下,轩轩进入了手术室。“大概切除了10厘米的肠子。”张树英说。

据介绍,目前,为体重仅为680克的新生儿做手术,可能创广西最低体重患儿接受麻醉手术新纪录。张树英说,手术时,新生儿科医生到现场参与,这也是第一次让新生儿科介入手术中,目的就是为了给轩轩术后更好的护理。

术后仍有好几道关要闯

昨日上午,该院外科主任陈振添到新生儿科看望轩轩。监测显示,轩轩生命体征平稳。然而手术成功只是第一关,接下来,轩轩还有好几道关要闯,第二关是术后康复,第三关是二次手术,把肠子接回原处。

该院产科主任林红介绍,双胞胎本身就是早产的高危因素,另外还有感染或外力作用都可能导致早产。从产科病理来说,除了双胎,羊水过多、巨大胎儿、母亲有高血压这些情况,也会导致早产。

据了解,全面放开二孩后,高龄产妇越来越多。辅助生殖技术的应用增多,工作压力、环境因素造成孕期并发症增多等,都会造成新生儿早产率越来越高,低出生体重儿随之增多。林红提醒,除了定期做孕检,有高危因素的孕妇要做好早产的预测,一旦发现问题应及时入院处理。

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