早产、低出生体质量儿先天性肠闭锁预后分析

Prognosis of with congenital intestinal atresis in premature and low birth weight infants

目的探讨早产儿、低出生体质量儿(LBWI)先天性肠闭锁的预后,探索提高治愈率的因素。方法回顾性分析2013年1月至2016年1月就诊于山西省儿童医院,通过手术确诊并治疗的98例先天性肠闭锁患儿的临床资料,采用卡方检验比较早产儿、低出生体质量先天性肠闭锁患儿预后与术后的肠功能恢复、死亡率、伤口感染、非计划二次手术等之间的关系。结果先天性肠闭锁患儿早产儿组与足月儿组的死亡率分别为17.07%(7/41)、3.51%(2/57)(P=0.022);肠功能恢复率分别为21.95%(9/41)、47.36%(27/57)(P=0.035);非计划二次手术率分别为12.19%(5/41)、8.77%(5/57)(P=0.581);伤口感染率分别为9.75%(4/41)、7.02%(4/57)(P=0.525)。出生孕周数与患儿术后的肠功能恢复及死亡率之间差异有统计学意义,与伤口感染及非计划二次手术之间差异无统计学意义。低出生体质量儿组与非低出生体质量儿组的死亡率分别为17.14%(6/35)、4.76%(3/63)(P=0.042);肠功能恢复率分别为22.86%(8/35)、44.44%(28/63)(P=0.006);非计划二次手术率分别为20.00%(7/35)、4.76%(3/63)(P=0.017);伤口感染率分别为14.28%(5/35)、4.76%(3/63)(P=0.099)。新生儿出生体质量与患儿术后的肠功能恢复、死亡率及非计划二次手术之间差异有统计学意义,与术后伤口感染之间差异无统计学意义。结论先天性肠闭锁患儿中,早产与低出生体质量是影响其预后的重要因素,应给予此类患儿更多的关注。

Objective To explore the prognosis of with congenital intestinal atresis in premature and low birth weight infants,to seek measures to improve the recovery rate.Methods Retrospective analyses were confirmed by surgery and treatment of the clinical data of 98 cases of children with congenital intestinal atresia,in the children's hospital of Shanxi Province,follow-ups were conducted with complete data during January 2013 to January 2013.By chi-square test compared the relationship between prognosis of premature and low birth weight infants with congenital intestinal atresia with postoperative intestinal function recovery,mortality rate,wound infection,non planned secondary surgery.Results In congenital intestinal atresis,preterm infants and full term group of mortality rates were 17.07%(7/41),3.51%(2/57)(P=0.022);the rates of postoperative intestinal function recovery were 21.95%(9/41),47.36%(27/57)(P=0.035);the rates of non planned secondary surgery were 2.19%(5/41),8.77%(5/57)(P=0.581);the wound infection rates were 9.75%(4/41),7.02%(4/57)(P=0.525),the born pregnant weeks with congenital intestinal atresia was statistically significant between postoperative intestinal function recovery and mortality;had not statistical significance between with and non planned secondary surgery.The mortality rates of low birth weight and no-low birth weight group were 17.14%(6/35),4.76%(3/63)(P=0.042);the rates of postoperative intestinal function recovery were 22.86%(8/35),44.44%(28/63)(P=0.006);the rates of non planned secondary surgery were 20.00%(7/35),4.76%(3/63)(P=0.017);the wound infection rates were 14.28%(5/35),4.76%(3/63)(P=0.099),neonatal birth weight was statistically significant between with postoperative intestinal function recovery,mortality rate and non planned secondary surgery;had not statistical significance between with wound infection.Conclusions Preterm and low birth weight is an important factor affecting the prognosis of congenital intestinal atresia,such infants should be given more attention.