Okafor Ugochukwu Vincent, Azike Jerome
Department of Anaesthesia, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.
Pan Afr Med J. 2009 Oct 16;3:7.
To review the anaesthetic management and outcome for emergency laparotomy for paediatric intestinal obstruction in the University of Nigeria Teaching Hospital, Enugu, Nigeria.
The anaesthetic charts and folders of pediatric patients that had emergency laparotomy for intestinal obstruction in the general operating theatre of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria, from October 2007 - September 2008 were reviewed. The records were examined for anaesthetic technique, patient primary diagnosis, intra-operative events, blood and fluid therapy and patient outcome. Patients above thirteen years were excluded.
Forty-four out of 285 (15.7%) paediatric patients underwent emergency laparotomy for intestinal obstruction in the general operating theatre. There were 29 males and 15 females. The average age of the patients was 3.75 years. There were a total of 1674 anesthetics in the general operating theatre during the study. The leading causes of intestinal obstruction in this study were typhoid peritonitis (14 or 31.8%), intussusceptions (14 or 31.8%) and congenital anomalies (11 or 25%). Six patients (13%) had a preoperative packed cell volume of less than 30%, while ten patients received intra-operative blood transfusion (21.7%). There was one anesthetic death to give a case mortality rate of 2.2%.
The mortality rate in this study shows the importance and relevance of trained providers of anaesthesia managing paediatric patients in the developing world. Early presentation of patients allowed time for resuscitation and fewer complications before surgery.
回顾尼日利亚埃努古尼日利亚大学教学医院小儿肠梗阻急诊剖腹手术的麻醉管理及结果。
回顾2007年10月至2008年9月在尼日利亚埃努古尼日利亚大学教学医院(UNTH)普通手术室因肠梗阻接受急诊剖腹手术小儿患者的麻醉记录和病历夹。检查记录中的麻醉技术、患者初步诊断、术中情况、血液及液体治疗和患者结局。排除13岁以上患者。
285例小儿患者中有44例(15.7%)在普通手术室因肠梗阻接受急诊剖腹手术。其中男性29例,女性15例。患者平均年龄为3.75岁。研究期间普通手术室共进行了1674例麻醉。本研究中肠梗阻的主要原因是伤寒性腹膜炎(14例,占31.8%)、肠套叠(14例,占31.8%)和先天性异常(11例,占25%)。6例患者(13%)术前红细胞压积低于30%,10例患者术中接受输血(21.7%)。有1例麻醉死亡,病例死亡率为2.2%。
本研究中的死亡率表明在发展中国家训练有素的麻醉医护人员管理小儿患者的重要性和相关性。患者尽早就诊可为术前复苏争取时间并减少并发症。