空肠营养管联合近端肠折叠术治疗先天性空肠闭锁的效果观察

Effect of jejunal nutrition tube combined with proximal intestinal folding in the treatment of congenital jejunal atresia

目的探究空肠营养管联合近端肠折叠术对先天性空肠闭锁患儿肠功能恢复、营养状况及生长发育的影响。方法选取我科2017年5月至2019年11月收治的先天性空肠闭锁患儿119例为研究对象,随机分为对照组59例和观察组60例。对照组给予肠管端端吻合术基础上联合近端肠折叠术,术后全静脉营养;观察组在对照组基础上联合空肠营养管治疗,对比两组患儿肠功能恢复(术后全静脉营养持续时间、经口喂养时间、经口喂养达40 mL/3 h时间、术后住院时间),营养状况(术后15 d及30 d前白蛋白、白蛋白水平),生长发育(身长周增长及体质量周增长),再手术及并发症情况。结果观察组术后全静脉营养持续时间、经口喂养时间、经口喂养达40 mL/3 h时间、术后住院时间均短于对照组,差异有统计学意义(P<0.05);观察组术后15 d和30 d前白蛋白水平和白蛋白水平均高于对照组,差异有统计学意义(P<0.05);观察组身高增长和体质量增长高于对照组,差异有统计学意义(P<0.05);两组术后1年再手术发生率和并发症情况比较差异无统计学意义(P>0.05)。结论空肠营养管联合近端肠折叠术通过更早恢复先天性空肠闭锁患儿肠功能和营养状态,促进生长发育,且不增加并发症和再次手术发生率。

Objective To explore the effects of jejunal nutrition tube combined with proximal intestinal folding on intestinal function recovery,nutritional status and growth and development in children with congenital jejunal atresia.Methods A total of 119 children with congenital jejunal atresia treated in our department from May 2017 to November 2019 were chosen and randomly divided into 59 cases in the control group and 60 cases in the observation group.The control group was given end-to-end intestinal anastomosis combined with proximal intestinal folding,and postoperative total venous nutrition;the observation group was treated with jejunal nutrition tube in addition to the treatment for the control group.The intestinal function recovery(postoperative total intravenous nutrition duration,oral feeding time,time of oral feeding up to 40 mL/3 h,postoperative hospital stay),nutritional status(prealbumin and albumin levels at 15 and 30 days after operation),growth and development(weekly growth of body length and body mass),reoperation and complications of the two groups were compared.Results The duration of total intravenous nutrition,oral feeding time,time of oral feeding up to 40 mL/3 h and postoperative hospital stay in the observation group were shorter than those in the control group(P<0.05).The levels of prealbumin and albumin in the observation group were significantly higher than those in the control group at 15 and 30 days after operation(P<0.05).The growth of height and body mass in the observation group was higher than that in the control group(P<0.05).There was no significant difference in reoperation rate or complications between the two groups one year after operation(P>0.05).Conclusion Jejunal nutrition tube combined with proximal intestinal folding can restore the intestinal function and nutritional status of children with congenital jejunal atresia sooner and promote growth and development without increasing the incidence of complications and reoperation.