产前诊断对小肠闭锁患儿预后的判断作用

The Estimable Effect of Antenatal Diagnosis on the Prognosis of Intestinal Atresia

目的:通过分析肠闭锁患儿产前诊断组(antenatal diagnosis,AND)与生后诊断组(postnatal diagnosis,PND)的预后,评估产前诊断对小肠闭锁患儿预后的判断作用。方法:回顾分析60例空回肠闭锁患儿,分为AND组和PND组,比较两组不同预后。结果:肠闭锁产前诊断率35%(21/60);空肠闭锁产前诊断率46.7%(14/30)高于回肠闭锁23.3%(7/30);AND组就诊时间和手术时间早于PND组;AND组平均住院天数、死亡率、术后大于7dTPN使用率和并发症发生率均高于PND组,后两个参数两组比较有显著差异,P<0.05。结论:AND肠闭锁患儿以空肠闭锁更为多见,虽其就诊时间和手术时间较PND组早,但其术后对TPN的依赖增加,术后住院天数和并发症增多,AND组肠闭锁患儿预后差于PND组。

Objective： The aim of this study is to determine whether patients with intestinal atresia diagnosed antenatally had different prognosis from those diagnosed postnatally. Methods：We reviewed the records of neonates in our hospital between 1995 and 2004 with a diagnosis of intestinal atresia. Results： Sixty neonates presented with intestinal atresia, with antenatal diagnosis （AND） being made in 21 （35%）. Jejunal atresia had a higher antenatal diagnostic rate than the ileal atresia patients. The AND group were operated on more quickly than those in the PND group. 17 out of 21（80%） in AND group required total parenteral nutrition longer than 7 days compared with 20 out of 39（51%） in the PND group, P〈0. 05. Complications in AND group were increased than those in PND group, 37.5% （6/16） vs 9. 7%（3/31）, P〈0. 05. Conclusion：Jejunal atresia is more common in AND than ileal atresia. Though AND group operated more quickly than PND group, it still had higher dependence on TPN, increased stay hospital days and complications. The prognosis of AND was poorer than that of PND group.