胆道闭锁术后患儿早期预后的相关因素分析

Analysis of related factors affecting early prognosis of children with biliary atresia

目的:探讨胆道闭锁(BA)术后患儿早期预后的相关影响因素。方法:选取2016年9月至2017年9月在广西医科大学第一附属医院小儿外科行开放或腹腔镜Kasai手术并术后规范化治疗达到出院标准的BA患儿40例,根据手术方式不同分为腹腔镜组(n=17)和开放组(n=23)。监测术后住院时间、术后首次排便时间、术后首次进食时间、术后有无并发症,分析影响患儿早期预后的相关因素。结果:与开放组相比,腹腔镜组术后进食时间早(P<0.001),手术时间长(P<0.001)。术后首次进食时间与手术方式、手术时间相关(P<0.05)。术后首次排便时间与术中是否体温监测和保暖相关,并且术中监测并采取保温措施的患儿术后相对能更早排便(P<0.05)。结论:BA患儿行腹腔镜手术后可较早恢复饮食,术中体温监测并采取保温措施的患儿术后能尽早排便。

Objective: To investigate the early related factors in children with biliary atresia (BA). Methods: The clinical data of 40 children with biliary atresia who underwent open operation( n =23) or laparoscopic Kasai operation( n =17) in our hospitalfrom September 2016 to September 2017 were retrospectively analyzed.Postoperative hospital days and postoperative first discharge,the time of defecation,the first time of eating after operation and the complications were recorded. Results: Compared with the open group,the postoperative feeding time of the laparoscopic group was earlier,but the operation time was longer ( P <0.001).Postoperative first meal time was related to operation mode and operation time ( P <0.05).Postoperative first defecation time was related to temperature monitoring and warmth preservation during operation,and the children who monitored and took heat preservation measures during operation could defecate earlier after operation ( P <0.05). Conclusion: Children with BA resumed their diet earlier after laparoscopic surgery.Monitoring temperature during operation and keeping warm could contribute to earlier defecation.