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1980 - 1985年爱尔兰新生儿坏死性小肠结肠炎的外科治疗

Surgery for neonatal necrotising enterocolitis in Ireland 1980-1985.

作者信息

Dykes E H, Fitzgerald R J, O'Donnell B

机构信息

Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland.

出版信息

Intensive Care Med. 1989;15 Suppl 1:S24-6. doi: 10.1007/BF00260879.

Abstract

Forty-seven infants were operated on for necrotising enterocolitis (NEC) in Ireland in a 6-year-period from 1980 to 1985. Incidence for surgical NEC in Ireland is 1/8733 live births. 44/47 patients were operated on during the acute phase and 3 patients had elective resection of strictures following conservative management. Indication for surgery in the acute phase was pneumoperitoneum in 37 infants. The initial procedure was: drainage alone in 10 patients, laparotomy and defunctioning enterostomy in 18, resection of the necrotic segment and proximal enterostomy in 15. 27/44 acute patients survived giving an overall mortality of 38.6% for acute NEC but mortality directly related to NEC was 31.8%. There was an inverse relationship between mortality and age at surgery. Medical treatment included total parenteral nutrition (TPN) in all patients for a mean time of 20.5 days.

摘要

1980年至1985年的6年间,爱尔兰有47名婴儿因坏死性小肠结肠炎(NEC)接受了手术。爱尔兰外科治疗NEC的发病率为每8733例活产中有1例。47例患者中有44例在急性期接受了手术,3例在保守治疗后接受了择期狭窄切除术。急性期手术的指征是37例婴儿出现气腹。初始手术方式为:10例患者仅行引流,18例行剖腹术及去功能化肠造口术,15例行坏死段切除术及近端肠造口术。44例急性期患者中有27例存活,急性NEC的总体死亡率为38.6%,但与NEC直接相关的死亡率为31.8%。死亡率与手术时的年龄呈负相关。所有患者均接受了平均20.5天的全胃肠外营养(TPN)治疗。

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