發(fā)布時間：2018-11-23 06:57

【摘要】：目的通過總結我院45例先天性食道閉鎖(congenital esophageal atresia CEA)患兒的診療經(jīng)驗,探討影響先天性食道閉鎖患兒術后并發(fā)癥的相關因素,為該病的臨床治療及并發(fā)癥的防治提供指導,提高食道閉鎖患兒的生存率及生活質量。資料與方法搜集鄭州大學第一附屬醫(yī)院小兒外科2010年9月至2016年9月確診為先天性食道閉鎖患兒的臨床資料,期間共診治患兒47例,男31例,女16例,其中2例因食管斷端距離大于3cm且合并高位肛門閉鎖,家屬拒絕手術、放棄治療自動離院;臨床分型均為Ⅲ型,Ⅲa型18例,Ⅲb型27例。通過門診復查及電話隨訪其預后情況,統(tǒng)計資料包括胎齡、出生體重、伴發(fā)畸形、盲端距離、手術日齡、手術時間、手術方式、腸內營養(yǎng)、術后并發(fā)癥、生存狀態(tài)等。采用回顧性分析方法,運用SPSS 19.0軟件分析資料數(shù)據(jù),了解胎齡、出生時體重、伴發(fā)畸形、盲端距離、手術方式、手術日齡、手術時間、早期腸內營養(yǎng)與術后并發(fā)癥的關系。結果45例均接受Ⅰ期食管吻合手術治療,術后14例出現(xiàn)并發(fā)癥,31例未出現(xiàn)并發(fā)癥。對比足月兒與早產(chǎn)兒,標準體重患兒與低體重患兒,開放手術與胸腔鏡手術患兒,早期腸內營養(yǎng)與全靜脈營養(yǎng)患兒,兩組間并發(fā)癥發(fā)生率的差異無統(tǒng)計學意義(P0.05);對比合并肺炎與未合并肺炎的患兒,盲端距離大于2cm的患兒與盲端距離小于2cm的患兒,伴發(fā)畸形與不伴畸形患兒,兩組間并發(fā)癥發(fā)生率的差異有統(tǒng)計學意義(P0.05);對比有并發(fā)癥與無并發(fā)癥患兒,兩組手術時間與手術日齡的差異無統(tǒng)計學意義(P0.05),對比早期腸內營養(yǎng)組與全靜脈營養(yǎng)組患兒住院時間與花費情況,差異具有統(tǒng)計學意義(P0.05)。結論1.肺炎、伴發(fā)畸形尤其是嚴重的心血管畸形可明顯增加先天性食道閉鎖患兒術后并發(fā)癥的發(fā)生率。2.盲端距離與患兒術后并發(fā)癥密切相關,術前應準確評估,選擇合適手術時機。3.早期腸內營養(yǎng)支持治療方法在縮短食道閉鎖患兒住院時間、減少醫(yī)療費用方面具有積極意義。
[Abstract]:Objective to summarize the experience in diagnosis and treatment of 45 children with congenital esophageal atresia (congenital esophageal atresia CEA) in our hospital, and to explore the related factors affecting the postoperative complications in children with congenital esophageal atresia, so as to provide guidance for the clinical treatment and prevention and treatment of congenital esophageal atresia. To improve the survival rate and quality of life of children with esophageal atresia. Materials and methods Clinical data of 47 children with congenital esophageal atresia diagnosed in pediatric surgery department of the first affiliated Hospital of Zhengzhou University from September 2010 to September 2016 were collected. In 2 cases, because the distance of the esophageal end was longer than 3cm and accompanied with high anal atresia, the family refused to operate and gave up the treatment to leave hospital automatically. All the patients were classified as type 鈪，

本文編號：2350696