提吊式肠造口术治疗足月新生儿先天性高位空肠闭锁的疗效研究

Clinical study of lifting enterostomy for congenital high jejunal atresia in term neonates

摘要:

目的 探讨提吊式肠造口术治疗足月新生儿先天性高位空肠闭锁的疗效。方法 选取2017年10月—2019年4月扬州大学附属医院108例足月新生儿先天性高位空肠闭锁患儿为研究对象，采用随机数字表法分为对照组和研究组，每组54例。对照组给予常规病变肠管切除吻合术，研究组给予提吊式肠造口术，术后随访3年。比较两组手术时间、术中出血量、肠功能恢复情况、术后并发症，以及近期生长、预后情况。结果 两组患儿手术时间、术中出血量比较，差异无统计学意义（P >0.05）。研究组术后排便时间、全静脉营养持续时间、术后经口进食时间、术后全量经口喂养时间短于对照组（P <0.05）。研究组总并发症发生率低于对照组（P <0.05）。截止随访结束，两组身高、体重比较，差异无统计学意义（P >0.05）。两组病死率、再手术率比较，差异无统计学意义（P >0.05）。结论 提吊式肠造口术治疗足月新生儿先天性高位空肠闭锁的疗效显著，可有效促进患儿术后肠功能恢复，且在安全性方面具有一定优势。

Abstract:

Objective To investigate the effect of lifting enterostomy in the treatment of congenital high jejunal atresia in term neonates.Methods A total of 108 full-term neonates with congenital high jejunal atresia who were treated Affiliated Hospital of Yangzhou University from October 2017 to April 2019 were selected as the research objects, and divided into a control group and a research group by random number table method, with 54 cases in each group. The control group was given routine bowel resection and anastomosis, and the study group was given lifting enterostomy. The patients were followed up for 3 years. The operation time and intraoperative blood loss in the two groups were recorded, the recovery of intestinal function in the two groups was recorded, the postoperative complications in the two groups were recorded, and the recent growth and prognosis of the two groups were recorded.Results There was no significant difference in operation time and intraoperative blood loss between the two groups (P > 0.05). The postoperative defecation time, total intravenous nutrition duration, postoperative oral feeding time and postoperative full oral feeding time in the study group were lower than those in the control group (P < 0.05). The total incidence of complications in the study group was lower than that in the control group (P < 0.05). At the end of follow-up, there was no significant difference in height and weight between the two groups (P >0.05). There was no significant difference in mortality and reoperation rate between the two groups (P > 0.05).Conclusion Lifting enterostomy in the treatment of term neonates with congenital high jejunal atresia has a significant effect, can effectively promote postoperative bowel function recovery, and has advantages in terms of safety.