Short-term follow-ups of postoperative complications and causes of death in neonates with meco-nium peritonitis
Objective To explore the postopetative complications and early death causes of meconium peritonitis(MP)and to improve its understanding.Methods From October 2011 to November 2021,the relevant clinical data were retrospectively reviewed for 67 MP children.There were 31 boys and 36 girls with an operative age of 1.63(1.17-2.80)days.Based upon survival status,they were assigned into two groups of survival(n=55)or death(n=12).The incidence of postoperative complications and the causes of death were examined.Perioperative profiles,prenatal diagnosis,early operation,postoperative pathology and postoperative complications were compared between two groups.Univariate and multivariate Logistic regression analyses were performed for determining the related factors of early death in MP patients.Results During a follow-up period of 6 months,postoperative complications occurred in 24/67 patients,including short bowel syndrome(n=7),incomplete intestinal obstruction(n=6),necrotizing enterocolitis(n=5),retraction/prolapse of fistula(n=2),septic shock(n=2),anastomotic leakage(n=1)and septicemia(n=1).Three deaths were due to abdominal infection,shock and multiple organ failure in hospital.And the remainders gave up treatments and died outside a hospital from short bowel syndrome(SBS,n=4),necrotizing enterocolitis(n=1),incomplete intestinal obstruction(n=1),anastomotic leakage(n=1),fistula orifice prolapse(n=1)and septicemia(n=1).The preoperative C-reactive protein(CRP)was higher in death group than that in survival group[(52.18±69.21)vs(10.08±17.02)mg/L].The inter-group difference was statistically significant(P＜0.001).Preoperative level of albumin was lower in death group than that in survival group[29.90(26.78,31.38)vs 32.10(28.80,35.20)g/L].And inter-group difference was statistically significant(P=0.036).Statistically significant inter-group differences existed in the proportion of children undergoing early surgery and those complicated by SBS(all P＜0.05).Clinical factors with P＜0.05 in univariate analysis were included for multivariate analysis.The results indicated that an elevation of preoperative CRP(OR=1.043,95％CI:1.009-1.078,P=0.012)and SBS(OR=17.929,95％CI:1.799-178.629,P=0.014)were the risk factors of death.Early surgery(OR=0.068,95％CI:0.006-0.709,P=0.025)was a protective factor for death in MP patients.Conclusions The major postoperative complications and early causes of death are SBS,intestinal inflammation and obstruction in MP patients.Early operation is essential for improving the cure rate.
NETL
NSTL
万方数据
维普
