肠腔减压引流对小肠吻合术病儿病情转归的影响

EFFECT OF INTESTINAL DECOMPRESSION DRAINAGE ON THE PROGNOSIS OF CHILDREN UNDERGOING SMALL INTESTINAL ANASTOMOSIS

目的探讨肠腔减压引流对小肠吻合术病儿病情转归的影响。方法对2013年1月—2018年1月我院收治的50例行小肠吻合术病儿进行回顾性分析,其中21例病儿术中采用吻合口近端小肠置管减压引流(置管组),29例病儿行常规小肠吻合术(常规组),比较两组病儿手术时间及术后首次排便时间、进食时间、住院时间、并发症发生率等。结果所有的病儿手术过程顺利,均于排便而且无腹胀后第2天拔除胃管。两组病儿手术时间比较差异无显著性(P>0.05),术后首次排便时间、进食时间、住院时间相比较,差异具有显著统计学意义(t=4.60、4.58,t′=3.84,P<0.05)。两组病儿术后并发症发生情况比较,差异具有显著统计学意义(χ~2=4.258,P<0.05)。病儿随访4个月～5年,均无吻合口狭窄、吻合口瘘及肠扭转等并发症发生。结论小肠吻合术病儿应用肠腔减压引流安全有效,有助于降低术后首次排便时间、进食时间及住院时间,降低术后并发症发生率,值得借鉴。

Objective To investigate the effect of intestinal decompression drainage on the prognosis of children under-going small intestinal anastomosis.Methods A retrospective analysis was performed for the clinical data of 50 children who were admitted to our hospital from January 2013 to January 2018 and underwent small intestinal anastomosis.Among these children,21 underwent small intestinal decompression drainage with the placement of a drainage tube near the anastomosis(tube placement group)and 29 underwent conventional small intestinal anastomosis(conventional group).The two groups were compared in terms of time of operation,time to first postoperative defecation,time to diet,length of hospital stay,and incidence rate of complications.Results All children underwent a successful surgery,and the gastric tube was removed on day 2 after defecation without abdominal distension.There was no significant difference in time of operation between the two groups(P>0.05),while there were significant differences in time to first postoperative defecation,time to diet,and length of hospital stay(t=4.60,4.59,t′=3.84,P<0.05).There was also a significant difference in the incidence rate of complications between the two groups(χ^2=4.258,P<0.05).The children were followed up for 4 months to 5 years,and no complications,such as anastomotic stenosis,anastomotic leak,and volvulus,were observed.Conclusion Intestinal decompression drainage is safe and effective in children undergoing small intestinal anastomosis and helps to reduce time to first postoperative defecation,time to diet,length of hospital stay,and incidence rate of postoperative complications.