本文選題：新生兒 + 腸外瘺�。� 參考：《南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版)》2017年07期

【摘要】：目的:探討腸液回輸對新生兒腸造瘺術(shù)后加速康復(fù)的意義。方法:回顧分析76例小腸造瘺的新生兒的臨床資料,據(jù)術(shù)后有無進(jìn)行腸液回輸分為研究組和對照組,觀察兩組患者術(shù)后3個月的體重變化、血清總蛋白、白蛋白、前白蛋白、視黃醇結(jié)合蛋白、首次再住院時間和遠(yuǎn)端腸管形態(tài)。結(jié)果:術(shù)后2周高、中、低位造瘺各組比較,研究組和對照組的體重及血清總蛋白、白蛋白、前白蛋白、視黃醇結(jié)合蛋白水平指標(biāo)差異無統(tǒng)計學(xué)意義。術(shù)后3個月高位造瘺研究組體重增長明顯優(yōu)于對照組[(1.2±0.3)vs.(0.8±0.4),P=0.03],高位造瘺研究組總蛋白、白蛋白比對照組稍增加[(57.1±7.6)vs.(54.3±9.3),P=0.71;(8.2±8.5)vs.(36.3±6.2),P=0.65],前白蛋白、視黃醇結(jié)合蛋白比對照組顯著增高[(92.0±23.1)vs.(81.2±21.7),P0.05;(21.6±8.1)vs.(16.5±5.5),P0.05);術(shù)后3個月中位造瘺研究組體重增長明顯優(yōu)于對照組[(1.7±0.4 vs.1.3±0.6,P=0.04),總蛋白、白蛋白比對照組稍增加[(60.3±10.3)vs.58.1±9.0,P=0.78;40.5±9.9 vs.39.4±7.8,P=0.86],前白蛋白、視黃醇結(jié)合蛋白比對照組顯著增高[(110.3±25.3)vs.92.0±21.2,P0.05;23.8±11.0 vs.18.3±8.9,P0.05];術(shù)后3個月低位造瘺研究組體重、總蛋白、白蛋白、前白蛋白、視黃醇結(jié)合蛋白均比對照組增加,但差異無統(tǒng)計學(xué)意義。中高位造瘺研究組首次再住院時間比對照組明顯延遲[(18.6±7.9)vs.14.2±5.2,P0.05;11.2±4.1vs.7.1±3.8,P0.05],灌腸造影顯示腸液回輸后遠(yuǎn)端腸管形態(tài)明顯優(yōu)于對照組。結(jié)論:腸液回輸能改善中高位腸造瘺術(shù)后新生兒的營養(yǎng)狀況和遠(yuǎn)端腸管形態(tài),加速患兒康復(fù)。
[Abstract]:Objective: to explore the significance of enteric fluid infusion in the accelerated recovery of neonatal enterostomy. Methods: the clinical data of 76 neonates undergoing enterostomy were retrospectively analyzed. According to the postoperative enteric fluid infusion, the patients were divided into study group and control group. The changes of body weight, serum total protein, albumin, prealbumin in the two groups were observed 3 months after operation. Retinol binding protein, first rehospitalization time and distal bowel morphology. Results: there was no significant difference in body weight, serum total protein, albumin, prealbumin, retinol binding protein between the two groups. 3 months after operation, the weight gain in the study group was significantly better than that in the control group [1. 2 鹵0.3)vs.(0.8 鹵0. 4P0. 03], and the total protein and albumin in the study group were slightly higher than those in the control group [57. 1 鹵7.6)vs.(54.3 鹵9. 3]. Retinol binding protein was significantly higher than that of the control group [92.0 鹵23.1)vs.(81.2 鹵21.7 鹵21.7 8.1)vs.(16.5 鹵5.5P0.05], and the weight gain of the study group was significantly better than that of the control group [1.7 鹵0.4 vs.1.3 鹵0.6 vs.1.3 鹵0.04G], and the total protein and total protein were slightly higher than those of the control group [60.3 鹵10.3)vs.58.1 鹵9.0PU 0.78 鹵0.78 鹵7.8P0.86], prealbumin, prealbumin, The retinol binding protein was significantly higher than that of the control group [110.3 鹵25.3)vs.92.0 鹵21.2 P0.05U 23.8 鹵11.0 vs.18.3 鹵8.9 p0.05], and the body weight, total protein, albumin, prealbumin and retinol binding protein were increased in the study group 3 months after operation, but there was no significant difference. The first time of rehospitalization in the study group was significantly delayed than that in the control group [18.6 鹵7.9)vs.14.2 鹵5.2 P0.05U 11.2 鹵4.1vs.7.1 鹵3.8p0.05]. The results of enema showed that the shape of distal intestinal tube was better than that of the control group. Conclusion: the recuperation of intestinal fluid can improve the nutritional status and distal intestinal shape of the newborn after middle and high enterostomy, and accelerate the recovery of the infant.
【作者單位】： 南京醫(yī)科大學(xué)附屬兒童醫(yī)院新生兒外科;
【基金】：南京市醫(yī)學(xué)科技發(fā)展重點(diǎn)項目(ZKX14033) 南京市科技發(fā)展計劃(201405015)
【分類號】：R722.1

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