Wang Jun, Du Lei, Cai Wei, Pan Weihua, Yan Wenbo
Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China.
Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China.
J Pediatr Surg. 2014 Nov;49(11):1593-7. doi: 10.1016/j.jpedsurg.2014.06.010. Epub 2014 Jul 30.
Although surgical interventions for intestinal atresia are usually successful, oral feed intolerance could raise in certain cases. The aim of this study was to identify the factors that affect postoperative oral feed by retrospective analysis.
Neonates meeting the inclusion criteria, who were admitted at our center from 1 January 2000 to June 2013, were enrolled into this retrospective study. Time to establishment of full oral intake (TOI), length of hospital stay (LOS) were outcome measures. Univariate and multiple regression were used.
Overall survival was 85.7%. Mean TOI was 20.4 ± 17.8 days, and mean LOS was 35.6 ± 44.8 days. Multivariate analysis confirmed a significant association with TOI for meconium peritonitis (P=0.024), luminal discrepancy between proximal and distal intestine (P=0.038), number of anastomoses (P=0.044), reportage of immature ganglion in proximal and/or distal intestine (P=0.029), and short bowel syndrome (P<0.001). Prematurity (P=0.022) increased the duration of hospitalization without affecting time to full oral intake.
Meconium peritonitis, luminal discrepancy, number of anastomoses, reportage of immature ganglion, and short bowel syndrome were factors related to prolonged feeding difficulties. We advocate alertness for patients with these factors to reduce postoperative morbidity and treatment costs.
尽管肠道闭锁的手术干预通常是成功的,但在某些情况下可能会出现口服喂养不耐受。本研究的目的是通过回顾性分析确定影响术后口服喂养的因素。
纳入2000年1月1日至2013年6月在本中心住院的符合纳入标准的新生儿进行这项回顾性研究。以完全经口摄入的建立时间(TOI)、住院时间(LOS)作为观察指标。采用单因素和多因素回归分析。
总体生存率为85.7%。平均TOI为20.4±17.8天,平均LOS为35.6±44.8天。多因素分析证实,胎粪性腹膜炎(P=0.024)、近端和远端肠腔差异(P=0.038)、吻合口数量(P=0.044)、近端和/或远端肠段神经节未成熟的报告(P=0.029)以及短肠综合征(P<0.001)与TOI显著相关。早产(P=0.022)会增加住院时间,但不影响完全经口摄入的时间。
胎粪性腹膜炎、肠腔差异、吻合口数量、神经节未成熟的报告以及短肠综合征是与喂养困难延长相关的因素。我们提倡对有这些因素的患者保持警惕,以降低术后发病率和治疗成本。