【摘要】 目的 通过胸腹联体双胎婴儿的分离手术提供联体婴儿外科治疗方法。方法 术前经 X 线、CT、MRI 和 B 超等检查确诊，该联体儿肝脏相连、膈肌相连，胸膜紧贴、心包紧贴，有2个完全独立的心脏，两副消化道和胆管。经1年的营养、护理、治疗后，在多科合作下成功地进行了联体分离手术。结果 术中见腹腔中有各自的消化道，共肝断面积 5cm ×6cm，胸腔中2个心包紧贴，2个胸膜紧贴，胸骨下段及 4～8 肋相连，均予完全分开。术后2个婴儿皆存活。 结论 联体婴儿术前正确评估、正确选用麻醉和手术方法、术后加强监护是手术成功的关键。

    【关键词】 双生；联体；外科手术；胸腹联胎

    One case of separation of thoracopagus conjoined twins

    REN Wan-wu, LI You-shan, WANG Min, et al.

    The Second People`s Hospital of Dazhou City，Dazhou 635000，China

    【Abstract】 Objective To sum up the experience in diagnosis and treatment of surgery by one case of separation of thoracopagus conjoined twins.Methods Thoracopagus twins were admitted for evaluating possible separation and repair before surgery.X-rays, CT, MRI and ultrasound scan of torso showed separated and normal gastrointestinal, biliary tracts and heart,conjoined pleura,conjoined pericardium,connected diaphragm and liver parenchyma. Surgery was successful held by several cooperative section after nutrition, nursing and treatment one year. Results They had normal separated gastrointestinal.The connected liver area were 5cm× 6cm.We successfully separated the connected liver parenchyma,sternums and the most inferior two pairs of the ribs, conjoined pleura,conjoined pericardium.They were alive well after surgery.Conclusion Careful preoperative evaluation,proper anesthesia, surgical technique and postoperative care are essential to successful surgery of the separation of the conjoined twins. ......