[1]位永娟,陳偉明,曾洪飚.新生兒壞死性小腸結(jié)腸炎46例腸造瘺術(shù)后并發(fā)癥及其影響因素分析[J].福建醫(yī)藥雜志,2022,44(01):23-27.
WEI Yongjuan,CHEN Weiming,ZENG Hongbiao.Analysis of postoperative complications and their influencing factors of neonatal necrotizing enterocolitis after enterostomy in 46 cases[J].FUJIAN MEDICAL JOURNAL,2022,44(01):23-27.
點(diǎn)擊復(fù)制
新生兒壞死性小腸結(jié)腸炎46例腸造瘺術(shù)后并發(fā)癥及其影響因素分析(
)
《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]
- 卷:
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44
- 期數(shù):
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2022年01期
- 頁(yè)碼:
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23-27
- 欄目:
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臨床研究
- 出版日期:
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2022-02-15
文章信息/Info
- Title:
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Analysis of postoperative complications and their influencing factors of neonatal necrotizing enterocolitis after enterostomy in 46 cases
- 文章編號(hào):
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1002-2600(2022)01-0023-05
- 作者:
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位永娟; 陳偉明; 曾洪飚
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福建省泉州市婦幼保健院 兒童醫(yī)院小兒外科(泉州362000)
- Author(s):
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WEI Yongjuan; CHEN Weiming; ZENG Hongbiao
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Department of Pediatric Surgery, Quanzhou Children's Hospital, Quanzhou, Fujian 362000, China
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- 關(guān)鍵詞:
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新生兒壞死性小腸結(jié)腸炎; 腸造瘺術(shù); 并發(fā)癥; 影響因素
- Keywords:
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neonatal necrotizing entercolitis; enterostomy; complication; influencing factors
- 分類(lèi)號(hào):
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R726.1
- 文獻(xiàn)標(biāo)志碼:
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B
- 摘要:
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目的 分析新生兒壞死性小腸結(jié)腸炎腸造瘺術(shù)后并發(fā)癥及相關(guān)影響因素，為減少并發(fā)癥發(fā)生提供參考。方法 回顧性分析2017年1月至2020年6月在我院診斷為新生兒壞死性小腸結(jié)腸炎行腸造瘺術(shù)的46例患兒的臨床資料，觀察其術(shù)后并發(fā)癥的發(fā)生和非計(jì)劃再手術(shù)情況，并對(duì)術(shù)后并發(fā)癥影響因素進(jìn)行單因素分析。結(jié)果 46例患兒中，1例放棄治療;其余45例，共發(fā)生并發(fā)癥16例，并發(fā)癥發(fā)生率達(dá)35.6%，死亡1例，死亡率2.2%，總生存率95.7%。非計(jì)劃再手術(shù)8例，非計(jì)劃再手術(shù)率17.8%。具體并發(fā)癥有造瘺口腸管脫垂1例，造瘺口腸管回縮2例，造瘺口狹窄1例，造瘺口近端腸穿孔和壞死4例，短腸及腸功能耐受不良6例，切口感染1例，死亡1例。結(jié)合關(guān)瘺時(shí)資料，共確診先天性巨結(jié)腸3例，誤診率6.7%。單因素分析顯示，患兒手術(shù)時(shí)不同Bell分期的術(shù)后并發(fā)癥發(fā)生率差異有統(tǒng)計(jì)學(xué)意義(P<0.05)，但是不同性別、出生胎齡、造瘺類(lèi)型、造瘺位置的術(shù)后并發(fā)癥發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。結(jié)論 新生兒壞死性小腸結(jié)腸炎死亡率高，腸造瘺是其目前的主要治療方式，及時(shí)手術(shù)介人可以減少并發(fā)癥的發(fā)生，患兒手術(shù)時(shí)不同Bell分期可能影響術(shù)后并發(fā)癥發(fā)生率。
- Abstract:
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Objective To analyze the postoperative complications and their influencing factors of neonatal necrotizing enterocolitis after enterostomy, and provide a basis for decreasing complications. Methods The clinical data of 46 children diagnosed with neonatal necrotizing enterocolitis in our hospital from January 2017 to June 2020 were analyzed retrospectively. The occurrence of postoperative complications and unplanned reoperation were observed. The influencing factors of the postoperative complications were analyzed by single factor analysis. Results Among 46 cases， 1 case was given up，the remaining 45 cases had a total of 16 complications，with the complication rate of 35.6%，1 case died, with the mortality rate of 2.2%，and the overall survival rate was 95.7%. A total of eight cases underwent unplanned reoperation，and the unplanned reoperation rate was 17.8%. Specific complications included one case of intestinal prolapse of the stoma，two cases of intestinal retraction of the stoma, one case of stomal stenosis, four cases of proximal intestinal necrosis and perforation， six cases of short bowel syndrome and intestinal dysfunction，one case of wound infection，and one case of death. Three cases of Hirschsprung's disease were diagnosed when the fistula was closed，and the misdiagnosis rate was 6.7%. Single factor analysis showed that there was significant difference in the incidence of postoperative complications between different Bell stages (P<0.05)，however, there were no significant differences in the incidence of postoperative complications between different genders， birth gestational ages, fistula types and fistula locations (P>0.05). Conclusion Neonatal necrotizing enterocolitis has a high mortality rate， and enterostomy is the main surgical method at present. Timely surgical intervention can reduce the incidence of complications. Different Bell stages may affect the incidence of postoperative complications.
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更新日期/Last Update:
2022-02-15