摘要
儿童肠重复畸形(ID)是一种罕见的先天性消化道发育异常,以回肠最为多见(占比50%),十二指肠及结肠发病相对罕见,其病因机制主要以原肠腔化障碍学说相关。病理分型主要为囊肿型(80%)和管状型为主,不同分型及部位决定了相应的治疗策略。临床表现多样,常见症状包括腹痛、呕吐、腹部包块,严重者可并发肠梗阻、消化道出血等。超声为首选诊断方法,CT、放射性核素显像及内镜技术可作为辅助手段进行精准定位。手术切除是当前治疗的核心策略,其中腹腔镜技术因微创优势广泛应用,而达芬奇机器人手术系统虽能在一定程度上提升操作精度,但其成本效益比仍需进一步评估。无症状患儿是否需手术仍存争议,但多数观点倾向于早期干预,以预防恶变潜在的恶变风险。本文通过深入综述ID的发病机制、诊断及治疗方面的最新进展,特别强调多模态诊疗及微创技术在该疾病诊疗过程中的重要性,为临床提供有益参考。
Intestinal Duplication (ID) is a rare congenital anomaly of the digestive tract, most frequently occurring in the ileum (50% of cases), while duodenal and colonic involvement remains uncommon. Its pathogenesis is predominantly attributed to hindgut canalization disorders. Pathologically, ID is classified into two main subtypes: cystic type (80%) and tubular type, with treatment strategies determined by anatomical variations and lesion location. Clinical manifestations are heterogeneous, ranging from abdominal pain, vomiting, and palpable masses to severe complications such as intestinal obstruction and gastrointestinal hemorrhage. Ultrasonography serves as the primary diagnostic modality, complemented by CT, radionuclide imaging, and endoscopy for precise localization. Surgical resection remains the cornerstone of management. Minimally invasive approaches, particularly laparoscopic techniques, are widely adopted, whereas the Da Vinci robotic surgical system—despite enhancing operational precision—requires further cost-benefit evaluation. Although management of asymptomatic cases remains controversial, early intervention is generally recommended to mitigate potential malignant transformation risks. This review comprehensively updates the pathogenesis, diagnostic advancements, and therapeutic innovations in ID, with emphasis on multimodality diagnostic-therapeutic integration and the pivotal role of minimally invasive technologies in optimizing clinical outcomes.
出处
《临床医学进展》
2025年第7期1273-1282,共10页
Advances in Clinical Medicine
