精准医学杂志2024，Vol.39Issue(1) ：33-35,39.DOI:10.13362/j.jpmed.202401008

新生儿坏死性小肠结肠炎84例手术疗效分析

Surgical outcome of neonates with necrotizing enterocolitis:An analysis of 84 cases

崔楷悦 宋华 谢恒翠 薛媛 李梦娇
精准医学杂志2024，Vol.39Issue(1) ：33-35,39.DOI:10.13362/j.jpmed.202401008
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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 维普
  • 万方数据

新生儿坏死性小肠结肠炎84例手术疗效分析

Surgical outcome of neonates with necrotizing enterocolitis:An analysis of 84 cases

崔楷悦 1宋华 1谢恒翠 1薛媛 1李梦娇1
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作者信息

  • 1. 青岛市妇女儿童医院新生儿外科,山东 青岛 266034
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摘要

目的 分析我院行手术治疗的新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)患儿的诊疗资料,为临床最佳手术时机和手术方式的选择提供参考.方法 回顾性分析 2015 年 1 月—2020 年 12 月本院收治的 84 例 NEC患儿的临床资料,所有患儿均行腹部平片检查,术中根据患儿肠管坏死部位及范围行肠造瘘术或坏死肠管切除肠吻合术,对患儿饮食、排便及体质量变化情况进行随访,并对患儿的手术治疗效果进行总结.结果 84 例患儿中,行肠减压腹腔引流术者 2 例;行肠造瘘术者 72 例,其中回肠造瘘 67 例,空肠远端造瘘 5 例;行坏死肠管切除肠吻合术者 7 例;放弃治疗者 3 例.患儿预后良好 77 例;预后不良 2 例,系因短肠综合征术后需定期静脉营养支持;死亡 2 例,系术后 6 个月因坏死性肠炎死亡;放弃治疗 3 例,因系术中发现广泛肠坏死.结论 新生儿坏死性小肠结肠炎病死率高,肠造瘘是其目前的主要治疗方式,及时行手术治疗对 NEC患儿具有良好的治疗效果.

Abstract

Objective To investigate the diagnosis and treatment data of neonates with necrotizing enterocolitis(NEC)undergoing surgical treatment in our hospital,and to provide a reference for the selection of optimal surgical timing and approach in clinical practice.Methods A retrospective analysis was performed for the clinical data of 84 neonates with NEC who were admit-ted to our hospital from January 2015 to December 2020,and all neonates underwent plain abdominal radiography.During the sur-gery,enterostomy or resection of the necrotic intestinal canal followed by intestinal anastomosis was performed according to the lo-cation and extent of necrotic intestinal canal.The neonates were followed up to observe the changes in diet,defecation,and body weight,and their surgical outcome was summarized.Results Among the 84 neonates,2 underwent intestinal decompression and peritoneal drainage;72 underwent enterostomy,among whom 67 underwent ileostomy and 5 underwent distal jejunostomy;7 underwent resection of the necrotic intestinal canal followed by intestinal anastomosis;3 were withdrawn from treatment.Of all neonates,77 had good prognosis;2 had poor prognosis and required regular parenteral nutrition support due to short bowel syn-drome;2 died of necrotic enteritis at 6 months after surgery;3 were withdrawn from treatment due to extensive bowel necrosis ob-served during surgery.Conclusion Neonates with NEC tend to have a high mortality rate,and enterostomy is the main treat-ment method at present.Timely surgical treatment has a good therapeutic effect on children with NEC.

关键词

小肠结肠炎,坏死性/结直肠外科手术/预后/婴儿,新生

Key words

Enterocolitis,necrotizing/Colorectal surgery/Prognosis/Infant,newborn

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出版年

2024
精准医学杂志
青岛大学

精准医学杂志

ISSN：2096-529X
参考文献量25
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