Kang Hui-Ling, Zhao Yue-Zhi
Department of Neonatology, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050006, Hebei Province, China.
Department of Surgical Anesthesia, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050006, Hebei Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):102980. doi: 10.4240/wjgs.v17.i4.102980.
Congenital intestinal atresia (CIA) is a common intestinal malformation in the neonatal period, and surgery is currently the main treatment method. The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.
To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.
Twenty-six children diagnosed with neonatal CIA, treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024, were selected for this single-center prospective randomized controlled study. They were divided into two groups using envelope randomization: Enteral nutrition (EN) group ( = 13) and parenteral nutrition (PN) group ( = 13). Baseline and clinical characteristics were collected, and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction. Differences between the groups were analyzed using -test, test, and Fisher's exact test. Spearman's correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.
The time to bowel sound recovery (51.54 65.85, = 0.013) and first defecation (58.15 76.62, < 0.001) was shorter in the EN group compared to the PN group. Clinical improvements in the EN group, including discharge weight ( = 0.044), hospital stay ( = 0.027), white blood cell count ( = 0.023), albumin content ( = 0.013), and direct bilirubin content ( = 0.018), were also better than those in the PN group. No substantial differences in postoperative complications were found between the groups. Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation. Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation. Abdominal infection and an operation time > 2 hours may be risk factors for prolonged time to first defecation.
EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children. Future research should explore optimal EN practices to enhance clinical application and child health.
先天性肠闭锁（CIA）是新生儿期常见的肠道畸形，目前手术是主要治疗方法。术后喂养方式的选择对患儿胃肠功能恢复至关重要。
比较并分析不同术后喂养方式对先天性肠闭锁新生儿胃肠功能重建的影响。
选取2021年1月至2024年5月在石家庄市妇幼保健院接受微创手术治疗的26例诊断为新生儿先天性肠闭锁的患儿，进行单中心前瞻性随机对照研究。采用信封随机法将其分为两组：肠内营养（EN）组（n = 13）和肠外营养（PN）组（n = 13）。收集基线和临床特征，将肠鸣音恢复时间和首次排便时间作为胃肠功能重建的评估指标。采用t检验、χ²检验和Fisher精确检验分析组间差异。采用Spearman相关性检验和线性回归模型分析影响首次排便时间的因素。
与PN组相比，EN组肠鸣音恢复时间（51.54±65.85，P = 0.013）和首次排便时间（58.15±76.62，P < 0.001）更短。EN组的临床改善情况，包括出院体重（P = 0.044）、住院时间（P = 0.027）、白细胞计数（P = 0.023）、白蛋白含量（P = 0.013）和直接胆红素含量（P = 0.018），也优于PN组。两组术后并发症无显著差异。相关性分析表明，腹腔感染和手术时间可能与首次排便时间有关。线性回归分析显示，肠内营养喂养与较短的首次排便时间之间存在显著关联。腹腔感染和手术时间>2小时可能是首次排便时间延长的危险因素。
肠内营养可显著促进新生儿先天性肠闭锁术后胃肠功能恢复，并可改善患儿临床结局。未来研究应探索最佳肠内营养方案，以加强临床应用和儿童健康。
