先天性肠闭锁术后喂养困难相关因素分析

发布时间：2018-04-07 00:00

本文选题：肠闭锁　切入点：术后经口喂养　出处：《上海交通大学》2014年硕士论文

【摘要】：背景：近年来，随着医疗水平的进步，先天性肠闭锁患儿存活率已显著提高，但临床工作中往往面临肠闭锁术后肠动力障碍，术后无法耐受经口喂养，需要长期静脉营养支持，费用高，预后差本文就肠闭锁患儿术后肠动力障碍的原因进行探讨分析方法：回顾性分析上海交通大医学院附属新华医院小儿外科2000年1月至2013年6月收治的先天性肠闭锁患儿临床资料应用Cox比例风险模型（单因素与多因素逐步回归）检验各因素与术后全量经口喂养时间及住院天数之间的关系结果：共有119例肠闭锁患儿被列入本次研究中，总生存率为85.7%平均术后全量喂养时间为20.4±17.8天，，平均住院天数为35.6±44.8天Cox多元逐步回归证实胎粪性腹膜炎（P=0.024）闭锁近远端肠管直径比（P=0.038）吻合口数目（P=0.044）闭锁近远端肠壁肠神经系统发育异常（P=0.029）和短肠综合征（P0.001）是影响肠闭锁患儿术后全量经口喂养时间的显著因素（P0.05）早产能显著增加肠闭锁患儿总住院天数（P=0.022）但不会影响术后全量经口喂养时间结论：小儿外科医生在处理肠闭锁合并胎粪性腹膜炎闭锁近远端肠管直径差异大吻合口数目多闭锁近远端肠壁肠神经系统发育异常和短肠综合征时，需小心谨慎以尽可能避免术后并发症降低治疗总费用
[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 卤17.8 days.The average hospitalization days were 35.6 卤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
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.5

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