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患有暂时性肠造口术的婴儿梗阻后肠病的十二指肠测压法

Duodenal manometry in postobstructive enteropathy in infants with a transient enterostomy.

作者信息

Cezard J P, Cargill G, Faure C, Boige N, Mashako L M, Munck A, Aigrain Y, Navarro J

机构信息

Service de Gastroentérologie Pédiatrique et de Chirurgie, Hôpital Robert Debre, Paris, France.

出版信息

J Pediatr Surg. 1993 Nov;28(11):1481-5. doi: 10.1016/0022-3468(93)90436-o.

Abstract

Intestinal motility was studied in 11 children with a transient enterostomy secondary to a neonatal organic small intestine obstruction (5 total colon Hirschsprung's disease, 2 necrotizing enterocolitis, 1 intussusception, 3 ileal atresia). Eight children presented with a postobstructive enteropathy (severe grade I [5], moderate grade II [3]) and three were considered as controls (grade III). They were assigned to one of the three groups on the basis of the duration of parenteral nutrition and constant rate enteral nutrition needed and the oral feeding tolerance. Barium small intestine transit showed no persistent partial obstruction or peritoneal adhesions. The abnormal inert marker transit times were statistically correlated with the clinical groups as well as duodenal manometric abnormalities. Manometric recordings were characterised by the absence (grade I) or abnormal phase III (grade II) of the migrating motor complex and decreased motility index (grades I and II). This study confirms that this enteropathy is due to a chronic alteration in motility induced by prenatal or postnatal obstructions.

摘要

对11例因新生儿器质性小肠梗阻行暂时性肠造口术的患儿(5例全结肠型先天性巨结肠、2例坏死性小肠结肠炎、1例肠套叠、3例回肠闭锁)的肠道动力进行了研究。8例患儿出现梗阻后肠病(重度Ⅰ级[5例]、中度Ⅱ级[3例]),3例被视为对照组(Ⅲ级)。根据肠外营养和持续速率肠内营养所需时间以及经口喂养耐受性,将他们分为三组之一。钡剂小肠通过检查未显示持续性部分梗阻或腹膜粘连。异常惰性标记物通过时间与临床分组以及十二指肠测压异常在统计学上相关。测压记录的特征为移行运动复合波缺失(Ⅰ级)或Ⅲ期异常(Ⅱ级)以及动力指数降低(Ⅰ级和Ⅱ级)。本研究证实,这种肠病是由产前或产后梗阻引起的动力慢性改变所致。

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