Adeyemi S D
Department of Surgery, College of Medicine, University of Lagos, Nigeria.
J Pediatr Surg. 1988 Feb;23(2):135-8.
The management of neonatal intestinal obstruction in developing countries remains challenging, but the results are relatively less rewarding compared with results of treatment of this condition in industrialized countries. This study is an attempt to evaluate, using acceptable scientific methods, some of the factors that are believed to influence survival in neonatal intestinal obstruction, including those that are not peculiar to developing countries alone. Sixty-five babies treated for intestinal obstruction at the Lagos University Teaching Hospital, Lagos, Nigeria, formed the subjects for the study. The levels of obstruction, which were congenital in all cases, spanned the entire intestinal tract from the duodenum to the anus. Forty-one babies survived and 24 died, a survival rate of 63%. Employing Student's t test, there were no significant differences in the gestational age and birth weight between survivors and nonsurvivors, whereas significant differences do exist with respect to the age at operation and admission serum bicarbonate levels, P less than .05 and P less than .001, respectively. Analysis of the levels of obstruction and nature of operative procedure using the chi-square test shows no significant differences between the two groups. However, there is significant difference in the percentage of major associated congenital problems, P less than .01, which was higher in nonsurvivors.
在发展中国家，新生儿肠梗阻的管理仍然具有挑战性，但与工业化国家治疗这种疾病的结果相比，其回报相对较低。本研究试图采用可接受的科学方法，评估一些被认为会影响新生儿肠梗阻存活率的因素，包括那些并非仅在发展中国家才有的因素。在尼日利亚拉各斯的拉各斯大学教学医院接受肠梗阻治疗的65名婴儿成为了该研究的对象。所有病例的梗阻均为先天性，范围从十二指肠到肛门，贯穿整个肠道。41名婴儿存活，24名死亡，存活率为63%。采用学生t检验，存活者与非存活者在胎龄和出生体重方面无显著差异，而在手术年龄和入院时血清碳酸氢盐水平方面存在显著差异，P值分别小于0.05和小于0.001。使用卡方检验分析梗阻水平和手术方式的性质，两组之间无显著差异。然而，主要相关先天性问题的百分比存在显著差异，P值小于0.01，非存活者中的比例更高。
