[1]位永娟,陈伟明,曾洪飚.新生儿坏死性小肠结肠炎46例肠造瘘术后并发症及其影响因素分析[J].福建医药杂志,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.
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新生儿坏死性小肠结肠炎46例肠造瘘术后并发症及其影响因素分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
44
期数:
2022年01期
页码:
23-27
栏目:
临床研究
出版日期:
2022-02-15

文章信息/Info

Title:
Analysis of postoperative complications and their influencing factors of neonatal necrotizing enterocolitis after enterostomy in 46 cases
文章编号:
1002-2600(2022)01-0023-05
作者:
位永娟; 陈伟明; 曾洪飚
福建省泉州市妇幼保健院 儿童医院小儿外科(泉州362000)
Author(s):
WEI Yongjuan;  CHEN Weiming;  ZENG Hongbiao
Department of Pediatric Surgery, Quanzhou Children's Hospital, Quanzhou, Fujian 362000, China
关键词:
新生儿坏死性小肠结肠炎; 肠造瘘术; 并发症; 影响因素
Keywords:
neonatal necrotizing entercolitis;  enterostomy;  complication;  influencing factors
分类号:
R726.1
文献标志码:
B
摘要:
目的 分析新生儿坏死性小肠结肠炎肠造瘘术后并发症及相关影响因素，为减少并发症发生提供参考。方法 回顾性分析2017年1月至2020年6月在我院诊断为新生儿坏死性小肠结肠炎行肠造瘘术的46例患儿的临床资料，观察其术后并发症的发生和非计划再手术情况，并对术后并发症影响因素进行单因素分析。结果 46例患儿中，1例放弃治疗;其余45例，共发生并发症16例，并发症发生率达35.6%，死亡1例，死亡率2.2%，总生存率95.7%。非计划再手术8例，非计划再手术率17.8%。具体并发症有造瘘口肠管脱垂1例，造瘘口肠管回缩2例，造瘘口狭窄1例，造瘘口近端肠穿孔和坏死4例，短肠及肠功能耐受不良6例，切口感染1例，死亡1例。结合关瘘时资料，共确诊先天性巨结肠3例，误诊率6.7%。单因素分析显示，患儿手术时不同Bell分期的术后并发症发生率差异有统计学意义(P<0.05)，但是不同性别、出生胎龄、造瘘类型、造瘘位置的术后并发症发生率差异无统计学意义(P>0.05)。结论 新生儿坏死性小肠结肠炎死亡率高，肠造瘘是其目前的主要治疗方式，及时手术介人可以减少并发症的发生，患儿手术时不同Bell分期可能影响术后并发症发生率。
Abstract:
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