Journal of Developmental Medicine(Electronic Version)  2021, Vol. 9 Issue (4): 248-253 DOI: 10.3969/j.issn.2095-5340.2021.04.002 |
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| Treatment and outcome analysis of 30 cases of meconium peritonitis |
| Wang Gang, Guo Feng, Zhang Lijuan, et al
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Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, ShanDong, Ji'nan 250021,China
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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.
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Received: 12 May 2021
Published: 29 July 2021
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