新生儿先天性巨结肠合并小肠结肠炎的临床治疗及高危因素

Analysis of Clinical Treatment And High Risk Factors of Hirschsprung's Disease With Enterocolitis in Neonates.

目的探讨新生儿先天性巨结肠合并小肠结肠炎(HAEC)的临床特点及治疗方案。方法回顾性分析146例新生儿先天性巨结肠及合并21例HAEC的临床资料。结果在合并HAEC的21例病例中,16例作粪培养均有致病菌生长;8例行肠造瘘术,其中7例治愈,1例死亡;保守治疗13例,4例治愈,9例死亡。手术和保守治疗两种方法的疗效经统计学处理,P<0.05,差异有统计学意义。结论HAEC是新生儿先天性巨结肠的严重并发症,也是该病的主要致死原因;HAEC的发生与细菌感染有关;一旦发生HAEC,手术治疗的治愈率高于保守疗法,及时的肠造瘘手术是挽救患儿生命的有效方法。

Objective To investigate the clinical characters and the best treatment scheme of hirschsprung＇s disease with enterocolitis in neonates. Methods One hundred and forty six HD patients were involved in this study, included 21 cases complicated with enterocolitis （HAEC）. The relationship of clinical character and mortality were analysed. Results 8 of 21 cases complicated with HAEC underwent intestinal fistulation; 7 cases were cured, one case death; The mortality of this group patients was 6.85% and each death case was enterocolitis. Twenty one patients suffered from HAEC, eight of them underwent intestineostomy, thirteen cases underwent conservative treatment, 4 cases cured; 9 cases death. Conclusion HAEC is a serious complication of Hirschsprung＇s Disease, and it is a main reason of death. HAEC is related with bacteria infection. If once occurs HAEC, cure rate of surgery therapy is high than that of conservative treatment, intestinal fistulation timely is efficacious way for save the sick neonates＇ life.