小婴儿先天性巨结肠肠造瘘的危险因素分析

Analysis of risk factors of enterostomy in infants with Hirschsprung’s disease

目的探讨小婴儿先天性巨结肠肠造瘘的危险因素,为临床工作者做出适时判断提供参考,并提高对治疗时机的把握。方法回顾性分析2013年1月至2019年1月重庆医科大学附属儿童医院收治的201例小婴儿先天性巨结肠临床资料,通过单因素和多因素Logistic回归分析患儿一般资料、临床表现及实验室检验结果,总结分析肠造瘘的危险因素。结果本组肠造瘘发生率22.4%,经多因素Logistic回归分析发现血清白蛋白降低(OR值=0.737,95%CI=0.633~0.857,P=0.000),大便常规异常(OR值=10.634,95%CI=3.016~37.502,P=0.000),PCT>2 ng/mL(OR值=9.954,95%CI=2.517~39.368,P=0.001),右侧型先天性巨结肠(OR值=4.307,95%CI=1.417~13.092,P=0.010)为本组患儿肠造瘘的危险因素。结论血清白蛋白降低、大便常规异常、PCT>2 ng/mL以及右侧型先天性巨结肠为小婴儿先天性巨结肠肠造瘘的危险因素。

Objective To explore the risk factors of enterostomy in infants with Hirschsprung’s disease(HSCR)to facilitate timely evaluation of the condition and the clinical decision-making on the timing of intervention.Methods We retrospectively analyzed the data of 201 infants diagnosed with HSCR in our hospital between January,2013 and January,2019.Univariate analysis and multivariate logistic regression were used to analyze the clinical data and laboratory test results of the patients to identify the risk factors of enterostomy.Results The incidence of enterostomy was 22.4%in these infants.Multivariate logistic regression analysis showed that lowered serum albumin level(OR=0.737,95%CI:0.633-0.857,P=0.000),abnormal stool routine(OR=10.634,95%CI:3.016-37.502,P=0.000),procalcitonin(PCT)level>2 ng/mL(OR=9.954,95%CI:2.517-39.368,P=0.001),and right-sided HSCR(OR=4.307,95%CI:1.417-13.092,P=0.010)were risk factors for enterostomy in infants.Conclusion A lowed serum albumin level,abnormal stool routine,a PCT level>2 ng/mL and right-sided HSCR are risk factors for enterostomy in infants with HSCR.