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贲门环扎术及改进的麻醉护理对一个发展中国家食管闭锁治疗效果的影响。

Effect of cardia banding and improved anaesthetic care on outcome of oesophageal atresia in a developing country.

作者信息

Ekenze Sebastian O, Ajuzieogu Obinna V, Nwankwo Elochukwu P

机构信息

Sub-Department of Paediatric Surgery, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

Department of Anaesthesia, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

出版信息

J Trop Pediatr. 2018 Dec 1;64(6):539-543. doi: 10.1093/tropej/fmx097.

Abstract

We comparatively analysed cases of oesophageal atresia (OA) managed in Enugu, south-eastern Nigeria from October 2010 to September 2015 to evaluate our short-term outcome with management following incorporation of temporary cardia banding to gastrostomy for late presenting cases and improved anaesthesia in 2013. Overall, 19 cases were analysed. The clinical parameters did not differ in the cases managed before (Group A) and after (Group B) these introductions. Four (21.1%) cases had primary repair (2 per group), six (31.6%) had delayed primary repair after treatment of pneumonitis (Group A 5; Group B 1) and nine (47.3%) had delayed primary repair after gastrostomy (Group A 4; Group B 5). Anaesthesia-related mortality dropped from 53.8 to 7.7% and survival improved from 9.1 to 62.5% following the introductions. Despite persisting barriers to care, outcome of OA in our setting may improve with better anaesthesia and incorporation of temporary cardia banding to gastrostomy.

摘要

我们对2010年10月至2015年9月在尼日利亚东南部埃努古接受治疗的食管闭锁(OA)病例进行了比较分析,以评估在2013年将临时贲门束带术应用于晚期病例的胃造口术并改善麻醉后我们的短期治疗效果。总体而言,分析了19例病例。在引入这些措施之前(A组)和之后(B组)管理的病例中,临床参数没有差异。4例(21.1%)进行了一期修复(每组2例),6例(31.6%)在治疗肺炎后进行了延迟一期修复(A组5例;B组1例),9例(47.3%)在胃造口术后进行了延迟一期修复(A组4例;B组5例)。引入这些措施后,与麻醉相关的死亡率从53.8%降至7.7%,生存率从9.1%提高到62.5%。尽管护理仍存在障碍,但在我们的环境中,通过更好的麻醉和将临时贲门束带术应用于胃造口术,OA的治疗效果可能会得到改善。

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