Department of Neonatal Surgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, 56 South Lishi Road, Xicheng District, Beijing, 100045, China.
Int J Colorectal Dis. 2022 May;37(5):1127-1132. doi: 10.1007/s00384-022-04151-5. Epub 2022 Apr 21.
This study was aiming to explore the risk factors contributing to enterostomy in neonates with Hirschsprung disease (HD) to provide a reference for clinicians to make treatment decisions.
Medical records of 284 patients diagnosed with HD during the neonatal period were retrospectively analyzed. The patients were divided into 2 groups based on operative intervention (one stage transanal pull-through, versus enterotomy and staged transanal pull-through). Univariate and multivariable logistic regression analysis was performed to identify risk factors contributing to enterostomy.
The incidence of enterostomy was 12.0% (34/284) in neonates with HD. Univariate and multivariate logistic regression analysis showed that serum albumin < 25.4 g/L, radiographic results as subphrenic free air, and level of aganglionosis with long-segment or total colonic aganglionosis (TCA) were independent risk factors of enterostomy in neonates, with OR of 42.045 (6.131, 288.319), 285.558 (26.651, 3059.694) and 15.573 (4.319, 56.157), respectively.
The low serum albumin level, bowel perforation, and level of aganglionosis with long-segment or TCA could influence the occurrence of enterostomy in neonates with HD.
本研究旨在探讨导致先天性巨结肠新生儿肠造口的危险因素，为临床医生制定治疗决策提供参考。
回顾性分析 284 例新生儿先天性巨结肠患者的病历资料。根据手术干预方式（一期经肛门拖出术与肠造口及分期经肛门拖出术）将患者分为两组。采用单因素和多因素逻辑回归分析确定导致肠造口的危险因素。
284 例先天性巨结肠新生儿中，肠造口发生率为 12.0%（34/284）。单因素和多因素逻辑回归分析显示，血清白蛋白<25.4 g/L、膈下游离气体的影像学结果以及长段或全结肠无神经节细胞症（TCA）的神经节细胞缺失程度是先天性巨结肠新生儿肠造口的独立危险因素，其 OR 值分别为 42.045（6.131，288.319）、285.558（26.651，3059.694）和 15.573（4.319，56.157）。
血清白蛋白水平低、肠穿孔和长段或 TCA 的无神经节细胞症缺失程度可能影响先天性巨结肠新生儿肠造口的发生。
