胎粪性腹膜炎, 肠闭锁, 炎症, 肠造瘘," /> 胎粪性腹膜炎, 肠闭锁, 炎症, 肠造瘘,"/> Meconium peritonitis, Intestinal atresia, Inflammation, Enterostomy,"/> <span style="font-size:14px;line-height:2;">30 例胎粪性腹膜炎治疗及转归分析</span>
Please wait a minute...
欢迎访问发育医学电子杂志,今天是
发育医学电子杂志  2021, Vol. 9 Issue (4): 248-253    DOI: 10.3969/j.issn.2095-5340.2021.04.002
  结构畸形   论著 |
30 例胎粪性腹膜炎治疗及转归分析
王刚 郭锋 张丽娟 焦晨炜 王帅
山东第一医科大学附属省立医院 小儿外科,山东 济南 250021
Treatment and outcome analysis of 30 cases of meconium peritonitis
Wang Gang, Guo Feng, Zhang Lijuan, et al
Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, ShanDong, Ji'nan 250021,China
下载:  PDF (1028KB) 
输出:  BibTeX | EndNote (RIS)      
摘要 【摘要】 目的  研究胎粪性腹膜炎(meconium peritonitis,MP)治疗及转归的影响因素。 方法 2015 年
2 月至2021 年2 月,在山东第一医科大学附属省立医院收治的MP 患儿30 例作为研究对象,探讨患儿
治疗情况及转归。入院后给予支持治疗后手术探查。肠造瘘患儿术后2 ~ 3 个月行肠造瘘口关闭术。
统计术后并发症发生情况、临床分型、手术方式及手术前后血C 反应蛋白(C-reactive protein,CRP)数值,采用SAS 9.4 进行统计分析。 结果  患儿30 例,男15 例,女15 例;平均出生胎龄为(36.9±1.9)周;平均出生体重为(3 120±555)g ;合并畸形14 例。其中弥漫性腹膜炎游离气腹型1 例,局限性腹膜炎包裹性气腹型4 例,新生儿肠梗阻型25 例。所有患儿生后均行腹部立位平片检查,发现肠梗阻征象29 例,
游离气腹征1 例,腹腔钙化征7 例。2 例患儿行上消化道造影,1 例提示包裹性气腹,另1 例提示高位肠
梗阻。1 例因感染性休克未手术死亡,29 例行手术治疗。其中1 例术后放弃治疗,28 例治愈,总治愈率
为93.33%。一期肠切除吻合术11 例,肠造瘘术18 例。一期肠吻合术组有3 例因黏连性肠梗阻再手术,
显著高于肠造瘘组,差异有统计学意义(P<0.05)。其余并发症有术后切口感染、营养不良、短肠综合征、
胆汁淤积等。临床分型与术后第7 天的 CRP 异常具有关联性,局限性腹膜炎包裹性气腹型为术后7 天
CRP 异常的危险因素,差异有统计学意义(P<0.05)。 结论 局限性腹膜炎包裹性气腹型MP 患儿较肠
梗阻型MP 患儿炎症恢复慢。一期肠吻合术后黏连性肠梗阻再手术发生率高于肠造瘘组。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
关键词:  line-height:2  胎粪性腹膜炎')" href="#">">胎粪性腹膜炎  肠闭锁  炎症  肠造瘘    
Abstract: 【Abstract】 Objective To study the influencing factors of the treatment of Meconium Peritonitis
(MP) and its outcome. Methods From February 2015 to February 2021, 30 neonates with MP were
admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University as research
subjects to investigate the treatment and outcome. After admission, surgical operation was performed after supportive treatment. Enterostomy closure was performed 2 to 3 months after enterostomy. The incidence of postoperative complications, clinical types, surgical methods, preoperative and postoperative blood CRP values were analyzed. SAS9.4 statistical software was used for statistical analysis. Results A total of 30 neonates with MP were counted, including 15 males and 15 females. The average gestational ages at birth were (36.9±1.9) weeks . The average birth weights were (3 120±555) g. There were 14 cases of associated deformity. Among of them, there were 1 case of general peritonitis and free pneumoperitoneum type, 4 cases of localized pneumoperitonitis and encapsulated pneumoperitoneum (pseudocyst) type, and 25 cases of intestinal obstruction type. After birth, all cases were examined by abdominal vertical radiograph, and 29 cases of intestinal obstruction, 1 case of free pneumoperitoneum and 7 cases of abdominal calcification were found. Upper gastrointestinal contrast was performed in 2 patients, including one with encapsulated pneumoperitoneum and another one with upper intestinal obstruction. One patient died from septic shock without surgery and 29 cases underwent surgery. One patient gave up after operation, 28 patients were cured, and the total cure rate was 93.33%. Primary intestinal resection and anastomosis was performed in 11 cases and enterostomy was performed in 18 cases. In the primary anastomosis group, 3 cases were reoperated due to adhesive ileus, which was significantly higher than that in the enterostomy group.The difference was statistically significant (P<0.05). Other complications included postoperative incision infection, malnutrition, short bowel syndrome and cholestasis. Clinical types were associated with CRP at 7 days postoperatively. Localized pneumoperitonitis and encapsulated pneumoperitoneum type was a risk factor for CRP at 7 days postoperatively. The difference was statistically significant (P<0.05). Conclusions Inflammatory recoveryis slower in neonates with localized pneumoperitonitis and encapsulated pneumoperitoneum type MPthan in neonates with intestinal obstruction type MP. The reoperation rate due to adhesive ileus in primaryanastomosis group is higher than that of enterostomy group.
Key words:  line-height:2    Meconium peritonitis')" href="#">">Meconium peritonitis    Intestinal atresia    Inflammation    Enterostomy
收稿日期:  2021-05-12                     发布日期:  2021-07-29     
基金资助: 10.3969/j.issn.2095-5340.2021.04.002
通讯作者:  王刚    E-mail:  2590617@qq.com
引用本文:    
王刚 郭锋 张丽娟 焦晨炜 王帅. 30 例胎粪性腹膜炎治疗及转归分析[J]. 发育医学电子杂志, 2021, 9(4): 248-253.
Wang Gang, Guo Feng, Zhang Lijuan, et al. Treatment and outcome analysis of 30 cases of meconium peritonitis. Journal of Developmental Medicine(Electronic Version), 2021, 9(4): 248-253.
链接本文:  
http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2021.04.002  或          http://www.fyyxzz.com/CN/Y2021/V9/I4/248
[1] 中国医师协会新生儿科医师分会 中国妇幼保健协会新生儿保健专业委员会 《发育医学电子杂志》编辑委员会. 胎盘输血专家共识[J]. 发育医学电子杂志, 2021, 9(4): 241-247.
[2] 郭润东 杨书龙 邰升 陆文君 李昭铸. 儿童胰腺实性假乳头状瘤的临床分析[J]. 发育医学电子杂志, 2021, 9(4): 254-258.
[3] 刘雪来 李龙 李索林 宋岩彪 杜娟 靳晓次 郑颖龙 费川 张永 婷. 采用电切法建立小鼠皮肤线形深Ⅱ°烫伤模型[J]. 发育医学电子杂志, 2021, 9(4): 259-262.
[4] 郎海雷 李凡 贵英斌 王子伟. 腹腔镜单部位腹内缝扎与单孔腹膜外结扎治疗儿童鞘膜积液对血清炎症因子的影响[J]. 发育医学电子杂志, 2021, 9(4): 263-267.
[5] 吴静静 包蕾 李禄全. 新生儿Prader-Willi 综合征临床诊疗思路[J]. 发育医学电子杂志, 2021, 9(4): 268-274.
[6] 达振强 王卫凯 邓兴强 白岩 何文华 侯风丽 蔺茹. 父亲因素与低出生体重儿发生的相关性分析[J]. 发育医学电子杂志, 2021, 9(4): 275-281.
[7] 胡凌云 谢潇潇 李立安 徐亚君 王黎 周飞虎 郭旭 游艳琴 卢 彦平. 产褥感染的病原菌分布及妊娠结局分析[J]. 发育医学电子杂志, 2021, 9(4): 282-286.
[8] 韦秋圆 黄素静 王茹 马燕琳. 子痫前期患者胎盘微小RNA-30d 表达与内质网应激的相关性分析[J]. 发育医学电子杂志, 2021, 9(4): 287-291.
[9] 陈佳 曲冬颖 曹岱 姜艳. 不同分娩方式的新生儿脐动脉血气分析比较[J]. 发育医学电子杂志, 2021, 9(4): 292-295.
[10] 翟晋慧 李娇龙 徐威 张源波 王自珍. 早期预警安全管理体系化护理对呼吸系统危急重症患儿的价值[J]. 发育医学电子杂志, 2021, 9(4): 296-300.
[11] 刘淑华 张玉东 蒲伟丛 房军臣 孟灵芝 贾超 马莉. 新生儿慢性肉芽肿病1 例[J]. 发育医学电子杂志, 2021, 9(4): 301-303.
[12] 吴婷 毛萌. 浅析母乳喂养的营养管理[J]. 发育医学电子杂志, 2021, 9(4): 304-309.
[13] 孙萌 李育霖 邹卉. 异戊酸血症的筛查与诊治现状[J]. 发育医学电子杂志, 2021, 9(4): 310-312, 320.
[14] 金玉 严滨 关怀. 妊娠合并系统性红斑狼疮的管理[J]. 发育医学电子杂志, 2021, 9(4): 313-316.
[15] 李国华 黄施佳 杜巧玲. 妊娠期甲状腺激素不足与妊娠结局的研究进展[J]. 发育医学电子杂志, 2021, 9(4): 317-320.
[1] Society of Neonatologist, Chinese Medical Doctor Association. Consensus recommendations on the prevention and early management of respiratory distress syndrome in preterm infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 129 -131 .
[2] Professional Committee of Respiratory, Society of Neonatologist, Chinese Medical Doctor Association. Clinical application recommendations for heated humidified high flow nasal cannula[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 132 -135 .
[3] GU Min-fang, YANG Chuan-zhong. Progress of intrapartum resuscitation for premature infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 141 -145 .
[4] GAO Xiao-hui, MAO Jian. Clinical features of non-oliguric hyperkalemia in extremely low birth weight infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 152 -158 .
[5] XIA Yao-fang, YANG Juan , TIAN Bao-li, et al. Value of amplitude-integrated electroencephalography in monitoring acute period of neonatal bilirubin encephalopathy and prognostic assessment[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 159 -163 .
[6] WANG Li-rong, SUN Xiao-yan, ZHU Ruo-xin, et al. Epidemiological investigation and analysis of women aged 40-55 years old with osteoporosis in Gansu province[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 164 -167 .
[7] CHEN Ru-yue, SHEN Yun-yan, CHEN Qing , et al. Five cases about Henoch-Schönlein purpura complicated with central nervous system injury in children and literatures review[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 168 -171 .
[8] ZHANG Ai-run, FANG Xiao-yi. Lung function testing of bronchopulmonary dysplasia for infants and children[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 172 -176 .
[9] LI Qiu-yu, LI Lu-quan. Risk factors and predictors for aggravation of neonatal necrotizing enterocolitis[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 177 -180 .
[10] ZHANG Sheng, FENG Zhi-chun. Application progress of matrix-assisted laser desorption/ionization-time of flight massspectrometry in the pathogenic microorganism detection and identification[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 177 -180 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed