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腹膜引流在极低出生体重儿肠穿孔中的应用价值:单中心经验

Usefulness of peritoneal drainage in extremely low birth weight infants with intestinal perforation: a single-center experience.

作者信息

Lee Ju Yeon, Namgoong Jung-Man, Kim Seong Chul, Kim Dae Yeon

机构信息

Department of Pediatric Surgery, Chonnam National University Children's Hospital, Gwangju, Korea.

Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2020 Mar;98(3):153-157. doi: 10.4174/astr.2020.98.3.153. Epub 2020 Feb 28.

Abstract

PURPOSE

Necrotizing enterocolitis and intestinal perforation are the most common surgical emergency in the neonatal intensive care unit. The purpose of this study is to evaluate if peritoneal drainage (PD) is beneficial in extremely low birth weight infants with intestinal perforation.

METHODS

Retrospective cohort study of extremely low birth weight infants with a diagnosis of intestinal perforation. They were received primary PD (n = 23, PD group) or laparotomy (n = 13, LAP group). Laboratory and physiologic data were collected and organ failure scores calculated and compared between preprocedure and postprocedures. Data were analyzed using appropriated statistical tests.

RESULTS

Between January 2005 and December 2015, 13 infants (male:female = 9:4) received laparotomy. Of 23 infants (male:female = 16:7) received PD, 20 infants received subsequent laparotomy. There were no demographic differences between PD and LAP groups. And there were no differences in total organ score in either group (PD, P = 0.486; LAP, P = 0.115). However, in LAP group, respiratory score was statistically improved between pre- and postprocedure organ failure score (P = 0.02). In physiologic parameter, PD group had a statistically worsening inotropics requirement (P = 0.025). On the other hand, LAP group had a improvement of PaO/FiO ratio (P = 0.01).

CONCLUSION

PD does not improve clinical status in extremely low birth weight infants with intestinal perforation.

摘要

目的

坏死性小肠结肠炎和肠穿孔是新生儿重症监护病房最常见的外科急症。本研究的目的是评估腹腔引流(PD)对极低出生体重儿肠穿孔是否有益。

方法

对诊断为肠穿孔的极低出生体重儿进行回顾性队列研究。他们接受了一期腹腔引流(n = 23,腹腔引流组)或剖腹手术(n = 13,剖腹手术组)。收集实验室和生理数据,计算并比较术前和术后的器官衰竭评分。使用适当的统计检验分析数据。

结果

2005年1月至2015年12月期间,13例婴儿(男:女 = 9:4)接受了剖腹手术。在23例接受腹腔引流的婴儿(男:女 = 16:7)中,20例婴儿随后接受了剖腹手术。腹腔引流组和剖腹手术组在人口统计学上无差异。两组的总器官评分也无差异(腹腔引流组,P = 0.486;剖腹手术组,P = 0.115)。然而,在剖腹手术组中,术前和术后器官衰竭评分之间呼吸评分有统计学意义的改善(P = 0.02)。在生理参数方面,腹腔引流组血管活性药物需求有统计学意义的恶化(P = 0.025)。另一方面,剖腹手术组的氧合指数(PaO/FiO)有所改善(P = 0.01)。

结论

腹腔引流不能改善极低出生体重儿肠穿孔的临床状况。

相似文献

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Surgical management of bowel perforations and outcome in very low-birth-weight infants (< or =1,200 g).
J Pediatr Surg. 2004 Feb;39(2):190-4. doi: 10.1016/j.jpedsurg.2003.10.005.

本文引用的文献

5
Treatment of intestinal perforation in extremely low-birthweight infants.
Pediatr Int. 2005 Aug;47(4):404-8. doi: 10.1111/j.1442-200x.2005.02100.x.
9
Necrotizing enterocolitis.坏死性小肠结肠炎
N Engl J Med. 1984 Apr 26;310(17):1093-103. doi: 10.1056/NEJM198404263101707.
10
Peritoneal drainage for necrotizing enterocolitis.
J Pediatr Surg. 1988 Jun;23(6):557-61. doi: 10.1016/s0022-3468(88)80368-3.

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