经鼻空肠营养管联合裁剪式肠吻合治疗新生儿高位空肠闭锁临床疗效分析

Clinical Efficacy of Nasojejunal Nutrition Tube Combined with Tailored Enterostomy in the Treatment of Neonatal High Jejunal Atresia

【目的】探讨经鼻空肠营养管联合裁剪式肠吻合术治疗新生儿高位空肠闭锁的临床疗效。【方法】回顾性分析2010年1月至2018年12月在南方医科天学珠江医院新生儿科收治的42例高位空肠闭锁患儿的临床资料.根据手术方式不同分成为对照组(肠吻合,n=20)和观察组(经鼻空肠营养管联合裁剪式肠吻合术,n=22).比较两组并发症发生率、住院时间、术后首次喂养时间、术后全量喂养时间的变化。【结果】观察组中无吻合口瘘的发生,术后出现肠梗阻1例.在术后d14行肠粘连松解术处理.术后恢复良好.对照组2例出现吻合口漏.术后出现肠梗阻4例,两组洽愈率、并发症发生率及病死率比较.差异有统计学意义(P<0.05)。观察组首次喂养时间、全量喂养和住院时间均显著低于对照组,差异有统计学意义(P<0.05)。【结论】经鼻空肠营养管联合裁剪式肠吻合术能提高新生儿先天性高位空肠闭锁的手术疗效、缩短住院时间,减少术后吻合口漏和肠梗阻的并发症的发生,是治疗先天性高位空肠闭锁较理想的术式。

【Objective】To investigate the clinical eHect of transnasal jejunal nutrition tube combined with tai-lored enterostomy in the.treatment of neonatal high jejunal atresia.【Methods】The clinical data of 42 children with high jejunal atresia admitted to the Department of Neonatology,Zhujiang Hospital,Southern Medical University from January 2010 to December 2018 were retrospectively analyzed.According to the different surgical methods,they were divided into control group(intestinal anastomosis,n=20)and observation group(nasojejunal nutrition tube combined with tailored enterostomy,n=22).The incidence of complications,hospital stay,the first feeding time after operation and the total feeding time after operation were compared between the two groups.【Results】There was no anastomotic leakage in the observation group and 1 case of intestinal obstruction after operation.On the 14th day after operation,intestinal adhesiolysis was performed.Postoperative recovery was good.In the control group,2 cases had anastomotic leakage and 4 cases had intestinal obstruction after operation.There were significant differences in the cure rate,complication rate and mortality between the two groups(P<0.05).The first feeding time,total feeding time and hospitalization time in the observation group were significantly lower than those in the control group(P〈0.05).【Conclusion】Transnasojejunal nutrition tube combined with tailored jeju-nostomy can improve the surgical effect of congenital high jejunal atresia,shorten the hospital stay,reduce the complications of anastomotic leakage and intestinal obstruction after operation,and is an ideal surgical method for the treatment of congenital high jejunal atresia.