CAJ | 학술논문

目的通过对10年来外科畸形低体重儿的围手术期治疗进行回顾性分析,为进一步提高外科畸形低体重新生儿的治愈率提供资料.方法 1996年1月～2006年8月期间上海交通大学医学院附属新华医院和上海儿童医学中心小儿外科收治的外科畸形低体重儿共104例,男69例,女35例,平均出生体重(2244±261)g(1 040～2490g),平均胎龄36+1周.分为2000年前(A组)共34例,2001年后(B组)共70例.结果外科畸形低体重儿占同期收治新生儿的9.5%,总治愈率为67.3%.41例患儿应用机械通气,平均机械通气时间为6.2 d,45例患儿应用全胃肠外营养(TPN),平均TPN应用时间9.5 d.A组的治愈率为58.8%,12例患儿应用机械通气,平均机械通气时间3.2 d;7例患儿应用TPN,平均应用TPN时间7.5 d.B组的治愈率为71.4%,29例患儿应用机械通气,平均机械通气时间8.4 d;38例患儿应用TPN,平均应用TPN时间19.4 d.比较两组的发病率、治愈率和围手术期的基本处理,两组在治愈率、机械通气和TPN的使用率、平均机械通气时间和TPN平均应用时间上差异存在统计学意义(P＜0.05).结论在围手术期应用合理、规范、有效的呼吸管理和营养支持,可以提高低体重儿畸形的治愈率.
목적 통과대10년래외과기형저체중인적위수술기치료진행회고성분석,위진일보제고외과기형저체중신생인적치유솔제공자료.방법 1996년1월～2006년8월기간상해교통대학의학원부속신화의원화상해인동의학중심소인외과수치적외과기형저체중인공104례,남69례,녀35례,평균출생체중(2244±261)g(1 040～2490g),평균태령36+1주.분위2000년전(A조)공34례,2001년후(B조)공70례.결과 외과기형저체중인점동기수치신생인적9.5%,총치유솔위67.3%.41례환인응용궤계통기,평균궤계통기시간위6.2 d,45례환인응용전위장외영양(TPN),평균TPN응용시간9.5 d.A조적치유솔위58.8%,12례환인응용궤계통기,평균궤계통기시간3.2 d;7례환인응용TPN,평균응용TPN시간7.5 d.B조적치유솔위71.4%,29례환인응용궤계통기,평균궤계통기시간8.4 d;38례환인응용TPN,평균응용TPN시간19.4 d.비교량조적발병솔、치유솔화위수술기적기본처리,량조재치유솔、궤계통기화TPN적사용솔、평균궤계통기시간화TPN평균응용시간상차이존재통계학의의(P＜0.05).결론 재위수술기응용합리、규범、유효적호흡관리화영양지지,가이제고저체중인기형적치유솔.
Objective To investigate the factors influencing the prognosis of LBW infants undergoing surgical management.Methods Between January 1996 and August 2006,104 LBW infants admitted to our department were enrolled in this study.Average birth weight was 244±261 g,and average gestational age was 36+1wk,respectively.They were divided into 2 groups depending on the admitring date as follows:patients of group A were admitted between January 1996 and December 2000,and group B was later than January 2001.Results The morbidity of LBW infants was 9.45%in neonates undergoing surgical management.The survival rate of LBW infants was 67.3%.Forty-one patients were performed mechanical ventilation,and average ventilation time was 6.2 days.Forty-five patients had received total parenteral nutrition(TPN),average time was 9.5 days.There was no significant difference in birth weight and gestational age between above 2 groups.Survival rate of group Awas 58.8%in contrast of 71.4% of group B In group A,12 patients had been performed mechanical ventilation for an average of 3.2 days,and 7 patients had received TPN for an average of 7.5 days.In group B,29 patients had been performed mechanical ventilation for an average of 8.4 days,and 38 patients had received TPN for an average of 19.4 days.The percentage and duration of mechanical ventilation in group B were higher than those in group A.There was significant difference in survival rate between these 2 groups(P＜0.05).Conclusions Assistant mechanical ventilation and TPN can improve the survival rate in LBW infants undergoing surgical management.