Anagnostopoulos D, Valioulis J, Sfougaris D, Maliaropoulos N, Spyridakis J
Pediatric Surgical Clinic, Aristotelian University, Thessaloniki, Greece.
Eur J Pediatr Surg. 1991 Oct;1(5):273-6. doi: 10.1055/s-2008-1042504.
This report concerns 59 infants and children with short bowel syndrome, most commonly caused by necrotizing enterocolitis in this study. Resection of atretic or gangrenous bowel was performed in 53 patients, tapering enteroplasty and primary anastomosis was performed in 13 patients, and temporary enterostomies were performed in 40 patients. Second-look laparotomy was useful in two of four cases of questionable bowel viability. The ileocecal valve was resected in 32 patients and remained intact in 27. The mean length of the remaining bowel was 58.4 cm. All patients received total parenteral nutrition and early enteral feedings. Home hyperalimentation was attempted when 50 per cent of the calorie intake was enteral. Intestinal adaptation required from 3 to 14 months. Frequent setbacks were related to catheter sepsis, rotavirus infection, carbohydrate intolerance, and liver dysfunction. The overall survival rate was 80 per cent with mortality due to sepsis associated with total parenteral nutrition and liver failure.
本报告涉及59例患有短肠综合征的婴幼儿，在本研究中最常见的病因是坏死性小肠结肠炎。53例患者进行了闭锁或坏疽肠段切除术，13例患者进行了肠管缩窄成形术和一期吻合术，40例患者进行了临时肠造口术。二次剖腹探查术对4例肠管存活情况存疑的病例中的2例有用。32例患者的回盲瓣被切除，27例保留完整。剩余肠管的平均长度为58.4厘米。所有患者均接受了全胃肠外营养和早期肠内喂养。当50%的热量摄入为肠内摄入时，尝试进行家庭胃肠外营养。肠道适应需要3至14个月。频繁的挫折与导管败血症、轮状病毒感染、碳水化合物不耐受和肝功能障碍有关。总体生存率为80%，死亡原因是与全胃肠外营养和肝功能衰竭相关的败血症。
