先天性食道闭锁术后并发症相关因素分析

发布时间：2018-11-23 06:57

【摘要】：目的通过总结我院45例先天性食道闭锁(congenital esophageal atresia CEA)患儿的诊疗经验,探讨影响先天性食道闭锁患儿术后并发症的相关因素,为该病的临床治疗及并发症的防治提供指导,提高食道闭锁患儿的生存率及生活质量。资料与方法搜集郑州大学第一附属医院小儿外科2010年9月至2016年9月确诊为先天性食道闭锁患儿的临床资料,期间共诊治患儿47例,男31例,女16例,其中2例因食管断端距离大于3cm且合并高位肛门闭锁,家属拒绝手术、放弃治疗自动离院;临床分型均为Ⅲ型,Ⅲa型18例,Ⅲb型27例。通过门诊复查及电话随访其预后情况,统计资料包括胎龄、出生体重、伴发畸形、盲端距离、手术日龄、手术时间、手术方式、肠内营养、术后并发症、生存状态等。采用回顾性分析方法,运用SPSS 19.0软件分析资料数据,了解胎龄、出生时体重、伴发畸形、盲端距离、手术方式、手术日龄、手术时间、早期肠内营养与术后并发症的关系。结果45例均接受Ⅰ期食管吻合手术治疗,术后14例出现并发症,31例未出现并发症。对比足月儿与早产儿,标准体重患儿与低体重患儿,开放手术与胸腔镜手术患儿,早期肠内营养与全静脉营养患儿,两组间并发症发生率的差异无统计学意义(P0.05);对比合并肺炎与未合并肺炎的患儿,盲端距离大于2cm的患儿与盲端距离小于2cm的患儿,伴发畸形与不伴畸形患儿,两组间并发症发生率的差异有统计学意义(P0.05);对比有并发症与无并发症患儿,两组手术时间与手术日龄的差异无统计学意义(P0.05),对比早期肠内营养组与全静脉营养组患儿住院时间与花费情况,差异具有统计学意义(P0.05)。结论1.肺炎、伴发畸形尤其是严重的心血管畸形可明显增加先天性食道闭锁患儿术后并发症的发生率。2.盲端距离与患儿术后并发症密切相关,术前应准确评估,选择合适手术时机。3.早期肠内营养支持治疗方法在缩短食道闭锁患儿住院时间、减少医疗费用方面具有积极意义。
[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，

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