外科性坏死性小肠结肠炎的死亡率和肠衰竭。

Mortality and intestinal failure in surgical necrotizing enterocolitis.

机构信息

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249-7335, USA.

出版信息

J Pediatr Surg. 2013 Mar;48(3):568-72. doi: 10.1016/j.jpedsurg.2012.11.028.

DOI:10.1016/j.jpedsurg.2012.11.028

Abstract

BACKGROUND/PURPOSE: To examine whether as initial surgical intervention for necrotizing enterocolitis, primary peritoneal drainage as compared to primary laparotomy is associated with increased mortality or intestinal failure.

METHODS

Retrospective observational study of 240 infants with surgical necrotizing enterocolitis.

RESULTS

There was no difference concerning the composite outcome of mortality before discharge or survival with intestinal failure after adjusting for known covariates (Odds Ratio 1.73, 95% CI 0.88, 3.40). More surviving infants in the peritoneal drainage with subsequent salvage or secondary laparotomy had intestinal failure compared to those who received a peritoneal drain without subsequent laparotomy and survived (12% vs. 14% vs. 1%, p=0.015).

CONCLUSIONS

There is no difference between peritoneal drainage and laparotomy in infants with surgical necrotizing enterocolitis concerning the combined outcome of mortality or survival with intestinal failure. There is increased intestinal failure in surviving infants treated with peritoneal drain with either subsequent salvage or secondary laparotomy compared to peritoneal drainage alone.

摘要

背景/目的：研究在患有坏死性小肠结肠炎的婴儿中，与初次剖腹术相比，初次腹腔引流术作为初始外科干预措施是否与死亡率或肠衰竭的增加相关。

方法

对 240 例患有手术性坏死性小肠结肠炎的婴儿进行回顾性观察性研究。

结果

在调整了已知协变量后，两组在出院前死亡率或生存伴有肠衰竭的复合结局方面无差异（优势比 1.73，95%置信区间 0.88，3.40）。与未接受后续剖腹术且存活的患儿相比，接受腹腔引流并随后进行挽救性或二次剖腹术的存活患儿中，发生肠衰竭的比例更高（12% vs. 14% vs. 1%，p=0.015）。