腹腔引流治疗新生儿坏死性小肠结肠炎的疗效观察

Efficacy of peritoneal drainage treatment of neonatal necrotizing enterocolitis

目的评价腹腔引流治疗新生儿坏死性小肠结肠炎(NEC)临床治疗效果,探讨治疗NEC的最佳途径。方法 2005年1月至2012年9月收治NEC 49例,临床分期为BellⅡ、Ⅲ期,30例行保守治疗,19例行腹腔引流术。比较两组的禁食时间、腹胀缓解时间、肠鸣音恢复时间、粪OB转阴时间、治愈率、死亡率、并发症、住院时间、中转手术率。结果腹腔引流组禁食时间、临床症状缓解时间、住院时间、死亡率、肠穿孔、肠狭窄和中转手术的发生率均明显低于保守治疗组。结论早期应用腹腔引流相对保守治疗提高BellⅡ、Ⅲ期NEC的治愈率,缩短禁食时间,较快改善临床症状,缩短住院时间,可降低肠坏死、肠穿孔、肠狭窄等并发症的发生。

Objective To evaluate the clinical effect of the peritoneal drainage treatment of neonatal necrotizing enterocolitis（NEC）,and the best way to explore the treatment of NEC.Methods A total of 49 cases NEC patients,clinical staging Bell Ⅱ,Ⅲ period were admittedfrom January 2005to September 2012,30patients were treated conservatively,19cases with routine intraperitoneal drainage.The two groups were compared by fasting time,bloating relief time,recovery time of bowel sounds,the negative fecal OB time,the cure rate,mortality,complications, length of hospital stay,transit operation rate.Results The fasting time,clinical symptoms,hospitalization time,mortality,intestinal perforation,intestinal stenosis and transit surgery incidence of peritoneal drainage group was significantly lower than that of conservative treatment group.Conclusion Early application of peritoneal drainage can improve the cure rate of BellⅡ,Ⅲ NEC,shorten the fasting time,rapid improvement of clinical symptoms,shorter hospital stays,lower intestinal necrosis,intestinal perforation,intestinal stenosis complications.