日本小児外科学会雑誌
Online ISSN : 2187-4247
Print ISSN : 0288-609X
ISSN-L : 0288-609X
重症心身障害児における胃食道逆流症の治療上の問題点
坂庭 操大川 治夫金子 道夫越智 五平堀 哲夫池袋 賢一滝田 齊
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1991 年 27 巻 4 号 p. 672-679

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This study is a review of our patients with gastroesophageal reflux who were severely retarded. Twelve mentally retarded patients who had undergone Nissen fundoplication and pyloroplasty during a period from 1980 through 1989 are the subjects of this study. Eight patients had cerebral palsy, two had Cornelia de Lange syndrome, one had West syndrome and the other had multiple minor anomalies. Eight patients were badly undernourished and their body weights were more than 2.7 standard deviations below the mean value. Vomiting stopped in ten patients after surgery, but wheezing persisted in three of them. Weight gain was observed in eight patients. Three patients have died from unknown causes. This study suggests : (1) Severely retarded children are at high risk of developing gastroesophageal reflux. Nissen fundoplication with pyloroplasty is effective treatment. The protective anti-reflux operation should be carried out when a tube gastrostomy is to be placed in them. (2) The patients often have hypertrophy of the left lobe of the liver, kypho-scoliosis and/or a ventricular-peritoneal shunt, which make the operation awkward.(3) Careful obsevation after surgery must be carried out.

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© 1991 特定非営利活動法人 日本小児外科学会

この記事はクリエイティブ・コモンズ [表示 - 非営利 - 継承 4.0 国際]ライセンスの下に提供されています。
https://creativecommons.org/licenses/by-nc-sa/4.0/deed.ja
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