提吊式肠造口术对吻合口径相差悬殊的肠闭锁患儿术后恢复的影响

Varying effects of hanging enterostomy on recovery after anastomosis with lopsided intestinal atresia

目的探讨吻合口径相差悬殊的先天性肠闭锁使用提吊式肠造口术后对术后肠道功能恢复的影响。方法回顾性分析2015年8月至2019年5月间收治的38例新生儿肠闭锁手术的临床资料,其中男25例,女13例。根据不同手术方式分为普通手术组(15例)和提吊式肠造口术组(23例)。对比分析两组患儿术后排便时间、进食时间、住院时间、术后并发症等指标的差异。患儿术后排便时间、进食时间、术后住院时间等计量资料组间比较采用t检验。结果提吊式肠造口术组患儿术后排便时间、进食时间、术后住院时间分别为(5±3.2)d、(6±3.2)d、(12±4.1)d,较普通手术组患儿(13±2.8)d、(12±2.8)d、(18±4.3)d短,组间比较,差异有统计学意义(P均<0.05)。普通手术组术后发生吻合口瘘1例,后再次行肠吻合术,预后良好;提吊式肠造口术组出现拔管时断管1例,1 d后自行排出。结论吻合口径相差悬殊的先天性肠闭锁患儿使用提吊式肠造口术有利于患儿术后肠道功能恢复,值得临床推广应用。

Objective To explore the varying effects of hanging enterostomy on postoperative intestinal function recovery in congenital intestinal atresia.Methods From August 2015 to May 2019,clinical data were reviewed for 38 surgical cases of neonatal intestinal atresia.There were 25 boys and 13 girls.They were divided into two surgical groups of normal intestinal atresia and hanging enterostomy.Postoperative defecation time,feeding time,postoperative bowel function recovery time and postoperative complications were statistically analyzed.And T-test was utilized for comparison.Results The postoperative defecation time,feeding time and postoperative hospital stay of the patients receiving hanging enterostomy was(5±3.2)d,(6±3.2)d,(12±4.1)d respectively,and that in patients receiving normal surgery was(13±2.8)d,(12±2.8)d,(18±4.3)d.The corresponding data between the two groups were statistically significant(P<0.05).In the general operation group,anastomotic leakage occurred in 1 case,and then intestinal anastomosis was performed again.In the hanging enterostomy group,the tube was broken in 1 case,which discharged after 1 day.Conclusions Postoperative defecation time,feeding time and postoperative complete recovery time of bowel function are significantly earlier in children with hanging enterostomy than those with routine surgery.Application of hanging enterostomy for congenital intestinal atresia can obviously promote the postoperative recovery of intestinal function.