Bishop-Koop肠吻合肠造口术治疗难治型先天性小肠闭锁的效果及对术后营养状况的影响

Effect of Bishop-Koop intestinal anastomosis for the treatment of refractory congenital small intestine atresia and its effect on postoperative nutritional status

目的分析Bishop-Koop肠吻合肠造口术治疗难治型先天性小肠闭锁的效果及对术后营养状况的影响。方法收集自2014年3月～2018年4月经治的32例难治型先天性小肠闭锁患儿,均给予Bishop-Koop肠吻合肠造口术治疗,评估术中及术后指标、术后并发症发生及不同时期营养状况改善情况。结果全组32例均顺利完成Bishop-Koop肠吻合肠造口术,平均手术时间(3.01±0.25)h,术中出血量(3.48±0.26)mL。术后首次肠内营养时间(11.26±2.60)d,术后肠外营养治疗时间(21.64±2.94)d,术后住院时间(25.68±5.41)d。全组术后并发症总发生率为18.75%(6/32)。全组术后出院时体质量Z评分正常率仅为18.75%,到造口闭合前达84.38%。结论针对难治型先天性小肠闭锁患儿,给予Bishop-Koop肠吻合肠造口术治疗效果确切,术后并发症少,且能够有效改善患儿术后营养,促进康复。

Objective To analyze the effect of Bishop-Koop intestinal anastomosis for the treatment of refractory congenital small intestine atresia and its effect on postoperative nutritional status. Methods 32 children with refractory congenital small intestine atresia who were treated from March 2014 to April 2018 were enrolled in this study. All patients were treated with Bishop-Koop intestinal anastomosis. The intraoperative and postoperative indicators, the intra- and post-operative complications and improvement of nutritional status in different periods were assessed. Results Bishop-Koop intestinal anastomosis was successfully performed in all 32 cases. The average operation time was(3.01±0.25) h, and the intraoperative blood loss was(3.48±0.26) mL. The postoperative first enteral nutrition time was the(11.26±2.60) day, and postoperative parenteral nutrition treatment time was(21.64±2.94)d, and postoperative hospital stay was(25.68±5.41)d. The overall incidence of postoperative complications in the whole group was 18.75%(6/32). The normal rate of body weight Z-score was only 18.75% after discharge in the whole group, and reached 84.38% before the stoma closure. Conclusion For children with refractory congenital small intestine atresia, Bishop-Koop intestinal anastomosis is effective, with less postoperative complications, and can effectively improve postoperative nutrition and promote rehabilitation.