肠液回输对新生儿小肠造瘘术后的加速康复作用

发布时间：2018-05-10 15:22

本文选题：新生儿 + 肠外瘘　；参考：《南京医科大学学报(自然科学版)》2017年07期

【摘要】：目的:探讨肠液回输对新生儿肠造瘘术后加速康复的意义。方法:回顾分析76例小肠造瘘的新生儿的临床资料,据术后有无进行肠液回输分为研究组和对照组,观察两组患者术后3个月的体重变化、血清总蛋白、白蛋白、前白蛋白、视黄醇结合蛋白、首次再住院时间和远端肠管形态。结果:术后2周高、中、低位造瘘各组比较,研究组和对照组的体重及血清总蛋白、白蛋白、前白蛋白、视黄醇结合蛋白水平指标差异无统计学意义。术后3个月高位造瘘研究组体重增长明显优于对照组[(1.2±0.3)vs.(0.8±0.4),P=0.03],高位造瘘研究组总蛋白、白蛋白比对照组稍增加[(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、视黄醇结合蛋白比对照组显著增高[(92.0±23.1)vs.(81.2±21.7),P0.05;(21.6±8.1)vs.(16.5±5.5),P0.05);术后3个月中位造瘘研究组体重增长明显优于对照组[(1.7±0.4 vs.1.3±0.6,P=0.04),总蛋白、白蛋白比对照组稍增加[(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、视黄醇结合蛋白比对照组显著增高[(110.3±25.3)vs.92.0±21.2,P0.05;23.8±11.0 vs.18.3±8.9,P0.05];术后3个月低位造瘘研究组体重、总蛋白、白蛋白、前白蛋白、视黄醇结合蛋白均比对照组增加,但差异无统计学意义。中高位造瘘研究组首次再住院时间比对照组明显延迟[(18.6±7.9)vs.14.2±5.2,P0.05;11.2±4.1vs.7.1±3.8,P0.05],灌肠造影显示肠液回输后远端肠管形态明显优于对照组。结论:肠液回输能改善中高位肠造瘘术后新生儿的营养状况和远端肠管形态,加速患儿康复。
[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 卤0.3)vs.(0.8 卤0. 4P0. 03], and the total protein and albumin in the study group were slightly higher than those in the control group [57. 1 卤7.6)vs.(54.3 卤9. 3]. Retinol binding protein was significantly higher than that of the control group [92.0 卤23.1)vs.(81.2 卤21.7 卤21.7 8.1)vs.(16.5 卤5.5P0.05], and the weight gain of the study group was significantly better than that of the control group [1.7 卤0.4 vs.1.3 卤0.6 vs.1.3 卤0.04G], and the total protein and total protein were slightly higher than those of the control group [60.3 卤10.3)vs.58.1 卤9.0PU 0.78 卤0.78 卤7.8P0.86], prealbumin, prealbumin, The retinol binding protein was significantly higher than that of the control group [110.3 卤25.3)vs.92.0 卤21.2 P0.05U 23.8 卤11.0 vs.18.3 卤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 卤7.9)vs.14.2 卤5.2 P0.05U 11.2 卤4.1vs.7.1 卤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.
【作者单位】：南京医科大学附属儿童医院新生儿外科;
【基金】：南京市医学科技发展重点项目(ZKX14033) 南京市科技发展计划(201405015)
【分类号】：R722.1

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