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新生儿十二指肠闭锁手术后不良结局的相关因素:一项回顾性研究

Factors Associated With Adverse Outcomes Following Duodenal Atresia Surgery in Neonates: A Retrospective Study.

作者信息

Deguchi Koichi, Tazuke Yuko, Matsuura Rei, Nomura Motonari, Yamanaka Hiroaki, Soh Hideki, Yoneda Akihiro

机构信息

Department of Pediatric Surgery, Graduate School of Medicine, Osaka University, Suita, JPN.

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, JPN.

出版信息

Cureus. 2022 Feb 17;14(2):e22349. doi: 10.7759/cureus.22349. eCollection 2022 Feb.

Abstract

Objectives There is limited evidence on the infants' postoperative complications who have undergone surgical repair of duodenal atresia and stenosis. This study aimed to identify the factors associated with poor surgical outcomes after the initial repair. Methods We retrospectively reviewed the data of 82 patients who underwent surgery for duodenal atresia and stenosis between January 1994 and December 2013 at our institution. Gestational age, birth weight, fetal growth, and other associated anomalies were recorded. Multivariate regression analyses were used to identify the factors associated with surgical outcomes, including postoperative complications and time to full oral intake. Results The median gestational age was 37.6 weeks, with 30 (37%) preterm (<37 weeks) and 11 (13%) early preterm (<34 weeks) infants. The median birth weight was 2531 g, with 27 (33%) patients < 2000 g and 10 (12%) patients < 1500 g. Postoperative surgical complications were identified in 18 (22%) cases, of which 12 (15%) required additional operations. Multivariate regression analysis revealed that a combination of very low birth weight (<1500 g) and early preterm was significantly associated with both surgical and non-surgical postoperative complications (p = 0.0028 and 0.021, respectively) and a prolonged time to full oral intake postoperatively (p = 0.013). Conclusion Very low birth weight and early preterm were significantly associated with postoperative complications and a prolonged time to full oral intake.

摘要

目的 关于接受十二指肠闭锁和狭窄手术修复的婴儿术后并发症的证据有限。本研究旨在确定初次修复后与手术效果不佳相关的因素。方法 我们回顾性分析了1994年1月至2013年12月在我院接受十二指肠闭锁和狭窄手术的82例患者的数据。记录了孕周、出生体重、胎儿生长情况及其他相关异常。采用多因素回归分析确定与手术效果相关的因素,包括术后并发症和完全经口进食时间。结果 中位孕周为37.6周,其中30例(37%)为早产(<37周),11例(13%)为极早早产(<34周)婴儿。中位出生体重为2531 g,27例(33%)患者<2000 g,10例(12%)患者<1500 g。18例(22%)出现术后手术并发症,其中12例(15%)需要再次手术。多因素回归分析显示,极低出生体重(<1500 g)和极早早产的组合与术后手术和非手术并发症均显著相关(分别为p = 0.0028和0.021),且术后完全经口进食时间延长(p = 0.013)。结论 极低出生体重和极早早产与术后并发症及完全经口进食时间延长显著相关。

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