本文選題：腸閉鎖　切入點(diǎn)：術(shù)后經(jīng)口喂養(yǎng)　出處：《上海交通大學(xué)》2014年碩士論文

【摘要】：背景：近年來(lái)，隨著醫(yī)療水平的進(jìn)步，先天性腸閉鎖患兒存活率已顯著提高，但臨床工作中往往面臨腸閉鎖術(shù)后腸動(dòng)力障礙，術(shù)后無(wú)法耐受經(jīng)口喂養(yǎng)，需要長(zhǎng)期靜脈營(yíng)養(yǎng)支持，費(fèi)用高，預(yù)后差本文就腸閉鎖患兒術(shù)后腸動(dòng)力障礙的原因進(jìn)行探討分析 方法：回顧性分析上海交通大醫(yī)學(xué)院附屬新華醫(yī)院小兒外科2000年1月至2013年6月收治的先天性腸閉鎖患兒臨床資料應(yīng)用Cox比例風(fēng)險(xiǎn)模型（單因素與多因素逐步回歸）檢驗(yàn)各因素與術(shù)后全量經(jīng)口喂養(yǎng)時(shí)間及住院天數(shù)之間的關(guān)系 結(jié)果：共有119例腸閉鎖患兒被列入本次研究中，總生存率為85.7%平均術(shù)后全量喂養(yǎng)時(shí)間為20.4±17.8天，，平均住院天數(shù)為35.6±44.8天Cox多元逐步回歸證實(shí)胎糞性腹膜炎（P=0.024）閉鎖近遠(yuǎn)端腸管直徑比（P=0.038）吻合口數(shù)目（P=0.044）閉鎖近遠(yuǎn)端腸壁腸神經(jīng)系統(tǒng)發(fā)育異常（P=0.029）和短腸綜合征（P0.001）是影響腸閉鎖患兒術(shù)后全量經(jīng)口喂養(yǎng)時(shí)間的顯著因素（P0.05）早產(chǎn)能顯著增加腸閉鎖患兒總住院天數(shù)（P=0.022）但不會(huì)影響術(shù)后全量經(jīng)口喂養(yǎng)時(shí)間 結(jié)論：小兒外科醫(yī)生在處理腸閉鎖合并胎糞性腹膜炎閉鎖近遠(yuǎn)端腸管直徑差異大吻合口數(shù)目多閉鎖近遠(yuǎn)端腸壁腸神經(jīng)系統(tǒng)發(fā)育異常和短腸綜合征時(shí)，需小心謹(jǐn)慎以盡可能避免術(shù)后并發(fā)癥降低治療總費(fèi)用
[Abstract]:Background: in recent years, with the progress of medical treatment, the survival rate of children with congenital intestinal atresia has increased significantly. However, the clinical work often faces intestinal motility disorder after intestinal atresia, which can not tolerate oral feeding and needs long-term venous nutrition support.The reason of intestinal motility disorder after operation in children with intestinal atresia is discussed and analyzed.Methods: the clinical data of children with congenital intestinal atresia treated in Xinhua Hospital affiliated to Shanghai Jiaotong University Medical College from January 2000 to June 2013 were analyzed retrospectively using Cox proportional risk model (univariate and multivariate stepwise regression).The relationship between the factors and total oral feeding time and length of stay after operationResults: a total of 119 children with intestinal atresia were included in this study. The overall survival rate was 85.7% and the mean total feeding time was 20.4 鹵17.8 days.The average hospitalization days were 35.6 鹵44.8 days by Cox multivariate stepwise regression analysis. The results showed that the number of anastomotic sites and the number of anastomotic sites in patients with meconium peritonitis were 0.024) and 0.038) (P < 0.044) and P0.029) and short bowel syndrome (P0.001) were associated with intestinal dysfunction.The significant factor of total oral feeding time after operation in atresia children (P0.05) premature delivery can significantly increase the total hospitalization days of children with atresia (P0.022) but will not affect the total oral feeding time after operation.Conclusion: in the treatment of intestinal atresia complicated with meconium peritonitis, the difference in diameter of proximal and distal intestinal canal is different in pediatric surgeons, and the number of large anastomotic stoma is multiple atresia proximal distal intestinal wall nervous system dysplasia and short bowel syndrome.Care should be taken to minimize postoperative complications and reduce the total cost of treatment
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R726.5

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本文編號(hào)：1719473