小肠内置管肠排列术治疗新生儿粘连性肠梗阻临床效果
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摘要
粘连性肠梗阻：因腹腔内肠袢与肠袢之间的粘连或肠袢与腹腔内其他脏器有粘连或索带形成压迫肠管而导致的肠梗阻。是小儿腹部外科的一种常见病及多发病。腹腔内粘连或索带的形成有两种：一种是先天性；一种是后天性。此次所要讨论的课题是先天性新生儿粘连性肠梗阻,先天性者多由于肠管发育畸形异常引起、目前对于先天性新生儿粘连性肠梗阻发病机制尚不清楚。胎粪性腹膜炎最多见、其次肠闭锁穿孔、梅克尔憩室等所致。新生儿粘连性肠梗阻多见于出生后几天内的小婴儿,患儿发生严重的急腹症症状前来就医。目前对粘连性肠梗阻发病率报道说法不一,北京儿童医院报道粘连性肠梗阻先天性占30%；上海新华医院报道占44.3%。可见新生儿粘连性肠梗阻所占比例比较大,但到目前为止,由于此病在治疗方法上未能获得突破性进展,故本病死亡率较高。经过学者多年的不断努力创新,在手术方式上逐渐改进,小肠内置管肠排列术是治疗粘连性肠梗阻的一种有效方法,但此手术方式多用于有多次手术史造成的粘连性肠梗阻,取得较满意的临床疗效。而对新生儿的临床应用报道很少,本文就小肠内置管肠排列术在治疗新生儿粘连性肠梗阻的临床应用及疗效进行研究,探讨新生儿小肠内置管肠排列术在临床推广应用有无价值提供参考。
目的
1.评价行小肠内置管排列术与未行小肠内置管排列术在治疗新生儿粘连性肠梗阻中的临床应用及疗效。
2.探讨小肠内置管排列术是否为治疗新生儿粘连性肠梗阻的一种有效的手术方法。
材料与方法
1.回顾性分析2000年1月—2012年10月河南省妇幼保健院小儿外科对新生儿粘连性肠梗阻行小肠内置管肠排列术的病例,随机抽取15例病案作为试验组,并将同时期未行小肠内置管肠排列术24例病案作为对照组。
2.将2组病例患儿预后肠梗阻复发例数、有无再次手术情况、术后生长发育情况及死亡情况等各项临床指标进行对比,并进一步分析肠内置管排列术在治疗新生儿粘连性肠梗阻的临床效果及应用价值。
3.所得数据运用SPSS17.0进行统计学分析,采用x2检验,检验水准α=0.05。
结果
1.试验组与对照组两组患儿的一般资料比较,差异无统计学意义。
2.将实验组与对照组两组患儿预后肠梗阻复发例数、有无再次手术情况及患儿预后生长发育情况临床指标进行x2检验分析(P<0.05)有意义。此种手术方式有优势,大部分患儿可免去再次行二次手术的痛苦。
结论
1.小肠内置管排列术比未行小肠内置管肠排列术在治疗新生儿粘连性肠梗阻中效果好具有优势,可临床推广应用。
2.小肠内置管排列术治疗新生儿粘连性肠梗阻的临床应用应视患儿的情况而定,选择应用。小肠内置管排列术可作为治疗新生儿粘连性肠梗阻的一种有效手术方法。
Intestinal obstruction:Due to the adhesions between intestinal loops in the intra-abdominal or adhesions or form to straps between bowel loops and other organs lead to Intestinal obstruction. It is a common and frequently-occurring disease of abdominal surgery in children. Intra-abdominal adhesions or straps formation is two situations:one is congenital; one is acquired. The topics to be discussed is congenital, the Congenital mostly due to intestinal abnormalities or meconium peritonitis.Neonatal intestinal obstruction is more common in the few days after birth, infants have severe symptoms of acute abdomen.At present about the reports of the intestinal obstruction is different, Beijing Children's Hospital reported the congenital of Intestinal obstruction is30%; Shanghai Xinhua Hospital is44.3%. so the proportion of newborn sticky ileus is more larger, but so far,because the disease is unable to obtain a breakthrough in the treatment, so the disease has a higher mortality rate. After continuous efforts of many years scholars innovation, continuous improvement of the surgical approach, small intestine built-in tube intestinal plication is an effective method for treatment of intestinal obstruction, but this surgical approach used for intestinal obstruction caused by several surgical history, and achieved satisfactory clinical efficacy. But few clinical reports of newborn, this article will discuss the small intestine catheter plication clinical application and efficacy in the treatment of newborn intestinal obstruction,and provide a reference value for the neonatal small intestine built-tube plication in the clinical application.
Objective
1. An evaluation of clinical application and efficacy about with the small intestine built-tube plication and without in the treatment of neonatal intestinal obstruction.
2. Explore the small intestine built-tube plication can become a new surgical approach for the treatment of neonatal intestinal obstruction.
Materials and methods
1. A retrospective analysis of the cases with implementation of the small intestine built-tube intestinal plication in Pediatric Surgery of the Maternal and Child Health Hospital of Henan Province between in January2000and2012in October,15cases were randomly selected medical records as a research group, and did not line the small intestine catheter plication intestinal the24cases medical record the same period as the control group.
2. Compared of ileus cases of recurrence, Operation situation again, Postoperative growth and development situation and other clinical indicators between two groups, and further analysis clinical application and efficacy of the intestinal catheter plication in the treatment of neonatal intestinal obstruction.
3.The data using SPSS17.0Statistical analysis and performed using x2test, P<0.05was statistically significant.
Results
1. General data of the two groups of children, there was no statistically significant difference. Compared of ileus cases of recurrence, Operation situation again, Postoperative growth and development situation and other clinical indicators between two groups(P<0.05). This operation method has an advantage, most children painful line again second operation can be avoided. The clinical application with line the intestinal catheter plication compared to without is better in the intestinal obstruction,and worthy of clinical application.
2. Intestinal catheter plication surgery is simple and easy to operate, no special contraindications, gastrointestinal function recovery was fast, good clinical effect and less complication, worthy of promotion.
Conclusions
1. The clinical application with line the intestinal catheter plication compared to without is better in the intestinal obstruction,and worthy of clinical application
2. The clinical application of the small intestine catheter plication in the newborn inintestinal obstruction depending on the circumstances. The small intestine catheter plication may be a new ways in the surgical treatment of neonatal adhesion ileus.
目的
1.评价行小肠内置管排列术与未行小肠内置管排列术在治疗新生儿粘连性肠梗阻中的临床应用及疗效。
2.探讨小肠内置管排列术是否为治疗新生儿粘连性肠梗阻的一种有效的手术方法。
材料与方法
1.回顾性分析2000年1月—2012年10月河南省妇幼保健院小儿外科对新生儿粘连性肠梗阻行小肠内置管肠排列术的病例,随机抽取15例病案作为试验组,并将同时期未行小肠内置管肠排列术24例病案作为对照组。
2.将2组病例患儿预后肠梗阻复发例数、有无再次手术情况、术后生长发育情况及死亡情况等各项临床指标进行对比,并进一步分析肠内置管排列术在治疗新生儿粘连性肠梗阻的临床效果及应用价值。
3.所得数据运用SPSS17.0进行统计学分析,采用x2检验,检验水准α=0.05。
结果
1.试验组与对照组两组患儿的一般资料比较,差异无统计学意义。
2.将实验组与对照组两组患儿预后肠梗阻复发例数、有无再次手术情况及患儿预后生长发育情况临床指标进行x2检验分析(P<0.05)有意义。此种手术方式有优势,大部分患儿可免去再次行二次手术的痛苦。
结论
1.小肠内置管排列术比未行小肠内置管肠排列术在治疗新生儿粘连性肠梗阻中效果好具有优势,可临床推广应用。
2.小肠内置管排列术治疗新生儿粘连性肠梗阻的临床应用应视患儿的情况而定,选择应用。小肠内置管排列术可作为治疗新生儿粘连性肠梗阻的一种有效手术方法。
Intestinal obstruction:Due to the adhesions between intestinal loops in the intra-abdominal or adhesions or form to straps between bowel loops and other organs lead to Intestinal obstruction. It is a common and frequently-occurring disease of abdominal surgery in children. Intra-abdominal adhesions or straps formation is two situations:one is congenital; one is acquired. The topics to be discussed is congenital, the Congenital mostly due to intestinal abnormalities or meconium peritonitis.Neonatal intestinal obstruction is more common in the few days after birth, infants have severe symptoms of acute abdomen.At present about the reports of the intestinal obstruction is different, Beijing Children's Hospital reported the congenital of Intestinal obstruction is30%; Shanghai Xinhua Hospital is44.3%. so the proportion of newborn sticky ileus is more larger, but so far,because the disease is unable to obtain a breakthrough in the treatment, so the disease has a higher mortality rate. After continuous efforts of many years scholars innovation, continuous improvement of the surgical approach, small intestine built-in tube intestinal plication is an effective method for treatment of intestinal obstruction, but this surgical approach used for intestinal obstruction caused by several surgical history, and achieved satisfactory clinical efficacy. But few clinical reports of newborn, this article will discuss the small intestine catheter plication clinical application and efficacy in the treatment of newborn intestinal obstruction,and provide a reference value for the neonatal small intestine built-tube plication in the clinical application.
Objective
1. An evaluation of clinical application and efficacy about with the small intestine built-tube plication and without in the treatment of neonatal intestinal obstruction.
2. Explore the small intestine built-tube plication can become a new surgical approach for the treatment of neonatal intestinal obstruction.
Materials and methods
1. A retrospective analysis of the cases with implementation of the small intestine built-tube intestinal plication in Pediatric Surgery of the Maternal and Child Health Hospital of Henan Province between in January2000and2012in October,15cases were randomly selected medical records as a research group, and did not line the small intestine catheter plication intestinal the24cases medical record the same period as the control group.
2. Compared of ileus cases of recurrence, Operation situation again, Postoperative growth and development situation and other clinical indicators between two groups, and further analysis clinical application and efficacy of the intestinal catheter plication in the treatment of neonatal intestinal obstruction.
3.The data using SPSS17.0Statistical analysis and performed using x2test, P<0.05was statistically significant.
Results
1. General data of the two groups of children, there was no statistically significant difference. Compared of ileus cases of recurrence, Operation situation again, Postoperative growth and development situation and other clinical indicators between two groups(P<0.05). This operation method has an advantage, most children painful line again second operation can be avoided. The clinical application with line the intestinal catheter plication compared to without is better in the intestinal obstruction,and worthy of clinical application.
2. Intestinal catheter plication surgery is simple and easy to operate, no special contraindications, gastrointestinal function recovery was fast, good clinical effect and less complication, worthy of promotion.
Conclusions
1. The clinical application with line the intestinal catheter plication compared to without is better in the intestinal obstruction,and worthy of clinical application
2. The clinical application of the small intestine catheter plication in the newborn inintestinal obstruction depending on the circumstances. The small intestine catheter plication may be a new ways in the surgical treatment of neonatal adhesion ileus.
引文
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