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全肠道灌洗:儿科患者的经验

Whole bowel irrigation: experience in pediatric patients.

作者信息

Vila J J, Gutierrez C, Garcia-Sala C, Ruiz S

出版信息

J Pediatr Surg. 1987 May;22(5):447-50. doi: 10.1016/s0022-3468(87)80267-1.

Abstract

Whole bowel irrigation (WBI) was used in 50 children aged 16 months to 14 years in preparation for surgery (n = 30) and colonoscopy (n = 20). The patients were divided into three groups according to age: group A, 12 to 36 months; group B, 3 to 6 years; and group C, 6 to 14 years. A hydroelectrolytic solution (Na 150 mEq/L, K 30 mEq/L, Cl 130 mEq/L, HCO3 50 mEq/L) was administered to all the groups at a variable rate established according to tolerance, weight, and age. Neomycin (1 g) and erythromycin (50 mg/kg) were administered in the last liter of the solution of the patients being prepared for colorectal surgery. Vital signs (heartbeat, arterial tension, and central venous pressure) and blood parameters (Na, K, HCO3, pH, and Hct) were assessed before and after irrigation and remained stable in all the groups. The rate of administration of the solution was best tolerated in each group as follows: group A, 75 mL/kg/h; group B, 60 mL/kg/h; and group C, 45 mL/kg/h. Colonic preparation was satisfactory in 49 of the 50 cases. Postoperative infectious complications were reduced to 3.3%. WBI in pediatric patients is a fast, simple, and well-tolerated method that gets a colon in excellent condition for surgery and colonoscopy exploration and considerably decreases the number of postoperative complications.

摘要

对50名年龄在16个月至14岁的儿童进行全肠道灌洗(WBI),为手术(n = 30)和结肠镜检查(n = 20)做准备。根据年龄将患者分为三组:A组,12至36个月;B组,3至6岁;C组,6至14岁。向所有组给予一种水电解质溶液(钠150毫当量/升,钾30毫当量/升,氯130毫当量/升,碳酸氢根50毫当量/升),给药速率根据耐受性、体重和年龄而定。在为结直肠手术准备的患者的最后一升溶液中给予新霉素(1克)和红霉素(50毫克/千克)。在灌洗前后评估生命体征(心跳、动脉压和中心静脉压)和血液参数(钠、钾、碳酸氢根、pH值和血细胞比容),所有组均保持稳定。每组对溶液给药速率的耐受性最佳情况如下:A组,75毫升/千克/小时;B组,60毫升/千克/小时;C组,45毫升/千克/小时。50例中有49例结肠准备情况良好。术后感染并发症降至3.3%。小儿患者的全肠道灌洗是一种快速、简单且耐受性良好的方法,可为手术和结肠镜检查使结肠处于极佳状态,并显著减少术后并发症的数量。

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