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儿童后天性肠道疾病切除术的适应症、类型及结果

Indications, Types and Outcomes of Resections for Acquired Intestinal Conditions in Children.

作者信息

Ezomike U O, Nwangwu E I, Ekenze S O

机构信息

Sub-Department of Pediatric Surgery, Faculty of Medical Sciences, College of Medicine University of Nigeria Teaching Hospital Ituku/Ozalla Campus,Nigeria.

Sub-Department of Pediatric Surgery University of Nigeria Teaching Hospital Ituku/Ozalla Enugu, Nigeria.

出版信息

West Afr J Med. 2020 Apr-Jun;37(2):118-123.

Abstract

BACKGROUND

Variable intestinal segments of children may need resection due to congenital or acquired conditions. Resection is done when these intestinal segments are nonviable or dysfunctional. In HICs most resections are for congenital conditions while in LMICs acquired and largely preventable conditions predominate.The spectrum of acquired intestinal conditions leading to bowel resection may also vary between HICs and LMICs.

OBJECTIVES

To determine the indications, types and outcomes of intestinal resection for acquired conditions in children.

METHODS

A retrospective review of pediatric bowel resections from acquired anomalies over a 10-year period in a tertiary hospital. Data entry and analysis done using SPSS. Fisher's exact test was used to assess level of significance for categorical variables and p-value of <0.05 was adjudged significant. Results are presented as means±SD, ratios, percentages and tables.

RESULTS

Fifty-nine males and thirty-three females with a median age of 8 months were recruited. Complicated intussusceptions and right hemicolectomy were the most common indication and procedure respectively. Proportion of right hemicolectomies was more in infants than older children (p=0.0103) while ileal resection was higher in older children (p<0.001). Post-operative complications were seen in 35.8% and mortality rate was 8.7%.

CONCLUSION

Complicated intussusception is the main acquired indication for intestinal resection. Right hemicolectomies and ileal resections were done mainly during infancy and beyond infancy respectively.

摘要

背景

由于先天性或后天性疾病,儿童的不同肠段可能需要切除。当这些肠段无法存活或功能异常时,就会进行切除。在高收入国家,大多数切除手术是针对先天性疾病,而在低收入和中等收入国家,后天性且大多可预防的疾病占主导。导致肠道切除的后天性肠道疾病谱在高收入国家和低收入及中等收入国家之间也可能有所不同。

目的

确定儿童后天性疾病肠道切除的适应症、类型和结果。

方法

对一家三级医院10年间因后天性异常进行的儿科肠道切除手术进行回顾性研究。使用SPSS进行数据录入和分析。采用Fisher精确检验评估分类变量的显著性水平,p值<0.05被判定为显著。结果以均值±标准差、比率、百分比和表格形式呈现。

结果

共招募了59名男性和33名女性,中位年龄为8个月。复杂肠套叠和右半结肠切除术分别是最常见的适应症和手术方式。婴儿中右半结肠切除术的比例高于大龄儿童(p = 0.0103),而大龄儿童的回肠切除术比例更高(p<0.001)。术后并发症发生率为35.8%,死亡率为8.7%。

结论

复杂肠套叠是肠道切除的主要后天性适应症。右半结肠切除术主要在婴儿期进行,回肠切除术主要在婴儿期之后进行。

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