Department of Surgery, Odense University Hospital, Odense C, DK-5000, Denmark.
J Pediatr Surg. 2011 Feb;46(2):352-6. doi: 10.1016/j.jpedsurg.2010.11.015.
BACKGROUND/PURPOSE: The aim of the present pilot study was to evaluate the safety and clinical application of intraperitoneal microdialysis (MD) in preterm infants operated on for necrotizing enterocolitis (NEC).
Fourteen infants underwent MD. Two were excluded from analysis: 1 because of catheter malfunction and 1 because of fatal outcome immediately after surgery. The median MD time was 122 hours. Samples were collected every 4 hours, and the concentration of glucose, lactate, pyruvate, and glycerol was measured.
Three infants were reoperated on: 2 because of recurrent NEC and 1 because of ileal stenosis. In the 2 cases with recurrent NEC, changes in MD variables were found. Another had a prolonged postoperative period owing to diffuse fecal peritonitis. The values of MD normalized along with the return of bowel function. In 8 infants, the postoperative course was uncomplicated. The results of peritoneal MD in patients with complications were significantly different from those with an uncomplicated course (lactate/pyruvate ratio and glucose concentration).
Peritoneal MD is a safe procedure and an applicable method in surveillance of the metabolic and inflammatory changes in the peritoneal cavity after surgery for NEC. Larger series are needed to evaluate the clinical significance and use of this method.
背景/目的：本初步研究旨在评估经腹腔内微透析（MD）在因坏死性小肠结肠炎（NEC）而行手术的早产儿中的安全性和临床应用。
14 名婴儿接受了 MD。2 名婴儿因导管功能障碍和 1 名婴儿因术后立即致命结局而被排除在分析之外。MD 的中位时间为 122 小时。每隔 4 小时采集一次样本，并测量葡萄糖、乳酸、丙酮酸和甘油的浓度。
3 名婴儿再次接受手术：2 名因复发性 NEC，1 名因回肠狭窄。在 2 例复发性 NEC 中，发现 MD 变量发生变化。另一名婴儿因弥漫性粪便腹膜炎而延长了术后期间。MD 值随着肠道功能的恢复而正常化。在 8 名婴儿中，术后过程顺利。有并发症的婴儿的腹膜 MD 结果与无并发症的婴儿明显不同（乳酸/丙酮酸比值和葡萄糖浓度）。
腹膜 MD 是一种安全的程序，也是监测 NEC 手术后腹腔代谢和炎症变化的一种适用方法。需要更大的系列来评估这种方法的临床意义和用途。
