腹腔引流治疗早产儿坏死性小肠结肠炎19例分析

Peritoneal Drainage Treatment Analysis of 19 cases of Necrotizing Enterocolitis in Preterm Children

目的评价腹腔引流治疗早产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。方法分析2005年1月至2013年01月收治NEC31例,临床分期为BellⅡ、Ⅲ期。12例行手术治疗,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、依赖静脉营养时间、治愈率、病死率、并发症、住院时间。结果腹腔引流组禁食时间、临床症状缓解时间、依赖静脉营养(TPN)时间、住院时间、病死率、肠狭窄及腹腔脓肿发生率均低于手术治疗组。结论早期应用腹腔引流相对手术治疗提高BellⅡ、Ⅲ期NEC的治愈率,缩短禁食时间,较快改善临床症状,缩短住院时间及静脉营养时间,可降低肠狭窄、腹腔内脓肿等并发症的发生。

Objective To evaluate the clinical effect of the peritoneal drainage necrotizing enterocolitis （NEC） for the treatment of premature children, to explore the best way to treat NEC. Method Admitted NEC31 cases, clinical staging Bell II, III period January 2005 to January 2013.12 patients underwent surgery, 19 patients peritoneal drainage. The two groups were compared fasting time, bloating relief time, recovery time of bowel sounds, the negative fecal OB time, dependent on parenteral nutrition time, the cure rate, mortality, complications, length of hospital stay. Results Peritoneal drainage group fasted time, clinical symptoms, duration of remission, dependent on parenteral nutrition （TPN） time, hospital stay, mortality, intestinal stenosis and abdominal abscess occurred were lower than surgical treatment group. Conclusion Early application peritoneal drainage the relative surgical treatment to improve Bell II, III cure rate of the NEC, shorter fasting time, rapid improvement of clinical symptoms and shorten the duration of hospitalization and parenteral nutrition time can reduce intestinal stenosis, intra-abdominal abscesses and other complications occur.