新生儿先天性肠旋转不良术后肠道功能恢复的影响因素分析

孙润物; 向广俊; 王佚; 刘伟

doi:10.16016/j.1000-5404.201903063

您当前的位置：

首页 >

文章列表页 >

新生儿先天性肠旋转不良术后肠道功能恢复的影响因素分析

临床医学 | 更新时间：2026-01-09

- 新生儿先天性肠旋转不良术后肠道功能恢复的影响因素分析
- Influencing factors for postoperative recovery of intestinal function in neonates with congenital intestinal malrotation
- 第三军医大学学报 2019年41卷第17期页码：1698-1702
- 作者机构：
  
  400014 重庆，重庆医科大学附属儿童医院胃肠新生儿外科，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室，重庆市儿童发育重大疾病诊治与预防国际科技合作基地
- 作者简介：
  
  [ 刘伟，E-mail:lw525761@126.com LIU Wei, E-mail:lw525761@126.com
- 基金信息：
  
  国家临床重点专科建设项目(国卫办医函〔2013〕544)
- DOI：10.16016/j.1000-5404.201903063
  中图分类号： R181.32;R722.19;R726.569
- 收稿：2019-03-07，
  
  修回：2019-06-11，
  
  纸质出版：2019-09-15
- 稿件说明：
移动端阅览
孙润物, 向广俊, 王佚, 等. 新生儿先天性肠旋转不良术后肠道功能恢复的影响因素分析[J]. 第三军医大学学报, 2019,41(17):1698-1702.

Runwu SUN, Guangjun XIANG, Yi WANG, et al. Influencing factors for postoperative recovery of intestinal function in neonates with congenital intestinal malrotation[J]. Journal of Third Military Medical University, 2019, 41(17): 1698-1702.
孙润物, 向广俊, 王佚, 等. 新生儿先天性肠旋转不良术后肠道功能恢复的影响因素分析[J]. 第三军医大学学报, 2019,41(17):1698-1702. DOI： 10.16016/j.1000-5404.201903063.

Runwu SUN, Guangjun XIANG, Yi WANG, et al. Influencing factors for postoperative recovery of intestinal function in neonates with congenital intestinal malrotation[J]. Journal of Third Military Medical University, 2019, 41(17): 1698-1702. DOI： 10.16016/j.1000-5404.201903063.

摘要

目的

探讨新生儿先天性肠旋转不良术后肠道功能恢复的影响因素。

方法

收集2012年1月至2019年1月208例于我科行手术治疗的新生儿先天性肠旋转不良患儿的临床资料，对可能影响该类患儿术后肠道功能恢复的因素进行回顾性分析。

结果

新生儿先天性肠旋转不良术后肠道功能恢复与孕母年龄、合并血便、合并肺炎、白蛋白值(入院时)、肠旋转程度无关(

0.05)。胎龄、出生体质量、合并腹膜炎、合并消化道畸形、联合手术、十二指肠近端直径与新生儿先天性肠旋转不良术后肠道功能恢复有关(

0.05)，其中与达到全肠内营养时间呈负相关的是胎龄(标准回归系数

=-0.206)、出生体质量(

=-0.307)，与达到全肠内营养时间呈正相关的是合并腹膜炎(

=0.220)、合并消化道畸形(

=0.344)、联合手术(

=0.412)、十二指肠近端直径(

=0.238)。多元回归分析结果提示出生体质量、合并腹膜炎、联合手术、十二指肠近端直径是达到全肠内营养时间的独立影响因素(

0.05)。

结论

出生体质量、合并腹膜炎、联合手术、十二指肠近端直径是新生儿肠旋转不良患儿术后肠道功能恢复的重要影响因素。

Abstract

Objective

To investigate the factors influencing the recovery of intestinal function after operation in neonates with congenital intestinal malrotation.

Methods

The clinical data of 208 neonates who underwent intestinal malrotation operation in our department from January 2012 to January 2019 were collected and retrospectively analyzed. The factors that might influence the recovery of intestinal function after operation were analyzed.

Results

Maternal age

hematochezia

pneumonia

albumin at admission

and rotation degree were unrelated to the recovery of intestinal function (

0.05). Gestational age

birth weight

peritonitis

digestive tract malformation

combined surgery

and proximal diameter of duodenum were positively associated with the recovery (

0.05). The negative influencing factors to the time of achieving full enteral nutrition were gestational age (

=-0.206) and birth weight (

=-0.307)

and the positively influencing factors were peritonitis(

=0.220)

digestive tract malformation (

=0.344)

combined surgery (

=0.412) and proximal diameter of duodenum(

=0.238). The results of multiple regression analysis showed that the independent influencing factors for the time of achieve full enteral nutrition were birth weight

peitonitis

combined surgery

and proximal diameter of duodenum (

0.05).

Conclusion

Birth weight

peitonitis

combined surgery

and proximal diameter of duodenum are important factors affecting the recovery of intestinal function in neonates with intestinal malrotation.

关键词

Keywords

references

蔡威, 孙宁, 魏光辉.小儿外科学[M]. 5版.北京:人民卫生出版社, 2014:297-301.

CAI W, SUN N, WEI G H. Pediatric surgery[M]. 5 ed.Beijing: People's Medical Publishing House, 2014:297-301.

NEHRA D, GOLDSTEIN A M. Intestinal malrotation: varied clinical presentation from infancy through adulthood[J]. Surgery, 2011, 149(3): 386-393. DOI:10.1016/j.surg.2010.07.004.

ABOAGYE J, GOLDSTEIN S D, SALAZAR J H, et al . Age at presentation of common pediatric surgical conditions: Reexamining dogma[J ] . J Pediatr Surg, 2014, 49(6): 995-999. DOI:10.1016/j.jpedsurg.2014.01.039.

姚楠.先天性肠旋转不良的X线及CT诊断[J].中国实用医药, 2011, 6(36): 57-58. DOI:10.3969/j.issn.1673-7555.2011.36.035.

YAO N. Diagnosis of congenital intestinal malrotation with X-ray and CT[J]. China Pract Med, 2011, 6(36): 57-58. DOI:10.3969/j.issn.1673-7555.2011.36.035.

ZHOU L Y, LI S R, WANG W, et al . Usefulness of sonography in evaluating children suspected of malrotation: comparison with an upper gastrointestinal contrast study[J ] . J Ultrasound Med, 2015, 34(10): 1825-1832. DOI:10.7863/ultra.14.10017.

ESPOSITO F, VITALE V, NOVIELLO D, et al . Ultrasonographic diagnosis of midgut volvulus with malrotation in children[J ] . J Pediatr Gastroenterol Nutr, 2014, 59(6): 786-788. DOI:10.10 97/MPG.0000000000000505.

ORZECH N, NAVARRO O M, LANGER J C. Is ultrasonography a good screening test for intestinal malrotation?[J]. J Pediatr Surg, 2006, 41(5): 1005-1009. DOI:10.1016/j.jpedsurg.2005.12.070.

TACKETT J J, MUISE E D, COWLES R A. Malrotation: Current strategies navigating the radiologic diagnosis of a surgical emergency[J]. World J Radiol, 2014, 6(9): 730-736. DOI:10.4329/wjr.v6.i9.730.

LANGER J C. Intestinal rotation abnormalities and midgut volvulus[J]. Surg Clin North Am, 2017, 97(1): 147-159. DOI:10.1016/j.suc.2016.08.011.

BIRAJDAR S, RAO S C, BETTENAY F. Role of upper gastrointestinal contrast studies for suspected malrotation in neonatal population[J]. J Paediatr Child Health, 2017, 53(7): 644-649. DOI:10.1111/jpc.13515.

CHANDRASEKARAN S, SHANMUGAM V. A study on clinical profile and outcome of malrotation of intestine in children[J]. Int Surg J, 2017, 4(6): 2054. DOI:10.18203/2349-2902.isj20172411.

EL-GOHARY Y, ALAGTAL M, GILLICK J. Long-term complications following operative intervention for intestinal malrotation: A 10-year review[J]. Pediatr Surg Int, 2010, 26(2): 203-206. DOI:10.1007/s00383-009-2483-y.

LODWICK D L, MINNECI P C, DEANS K J. Current surgical management of intestinal rotational abnormalities[J]. Curr Opin Pediatr, 2015, 27(3): 383-388. DOI:10.1097/MOP.0000000000000215.

GARGASZ A. Neonatal and pediatric parenteral nutrition[J]. AACN Adv Crit Care, 2012, 23(4): 451-464. DOI:10.1097/NCI.0b013e31826e8f8b.

PENAGINI F, MAESTRI L, ZUIN G, et al . Use of parenteral nutrition in pediatric general and surgical wards: Indications and complications[J ] . Digest Liver Dis, 2017, 49(4): e280. DOI:10.1016/j.dld.2017.09.102.

杨曼青.新生儿肠道手术术后肠道功能恢复及预后的影响因素[D].汕头: 汕头大学, 2015. [http://med.wanfangdata.com.cn/Paper/Detail/DegreePaper_D706982 .

YANG M Q. The multiple factors influencing intestinal function recovery and prognosis of neonates with intestinal surgery[D]. Shantou: Shantou University, 2015.

孙润物.新生儿先天性肠旋转不良术后肠道功能恢复的影响因素分析[D].重庆: 重庆医科大学, 2018.

SUN R W. Influence factors analysis for intestinal function recovery after operation in neonates with congenital intestinal malrotation[D]. Chongqing: Chongqing Medical University, 2018.

TEN BERGE F, TOLBOOM J J, BOETES C, et al . Surgical intervention of intestinal malrotations in paediatric patients without other congenital anatomical abnormalities: overview from a single center[J ] . Eur J Radiol, 2006, 59(1): 20-24. DOI:10.1016/j.ejrad.2006.03.013.

邵肖梅.早产儿消化系统的特点及喂养[J].中国实用儿科杂志, 2000, 15(12): 716-718. DOI:10.3969/j.issn.1005-2224.2000.12.004.

SHAO X M. Characteristics of digestive system and way of feeding in premature infants[J]. Chin J Pract Pediatr, 2000, 15(12): 716-718. DOI:10.3969/j.issn.1005-2224.2000.12.004.

PESSAUX P, MSIKA S, ATALLA D, et al . Risk factors for postoperative infectious complications in noncolorectal abdominal surgery: A multivariate analysis based on a prospective multicenter study of 4718 patients[J ] . Arch Surg, 2003 , 138(3): 314-324.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

呼吸重症监护室机械通气患者代理决策者决策冲突发生及影响因素分析

近足月及足月新生儿出生后24 h内住院及呼吸支持治疗的危险因素分析

以血便为首发症状的新生儿坏死性小肠结肠炎与食物蛋白过敏性直肠结肠炎的临床对比分析

经肛门一期根治术治疗新生儿巨结肠手术时机的探讨

非战争军事行动军人心理问题特点及影响因素