中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2014年
3期
195-198
,共4页
戚继荣%莫绪明%钱龙宝%李晓南
慼繼榮%莫緒明%錢龍寶%李曉南
척계영%막서명%전룡보%리효남
食管闭锁%肠营养%微量注射
食管閉鎖%腸營養%微量註射
식관폐쇄%장영양%미량주사
Esophageal atresia%Enteral nutrition%Microinjections
目的 探讨早期微泵肠内营养输注法在新生儿食管闭锁治疗中的必要性及对预后的影响.方法 回顾性分析1999年4月至2012年4月收治的新生儿Ⅲ型食管闭锁112例的临床资料.112例均采用食道一期吻合术.其中,1999-2006年的50例为常规治疗组,2006-2012年的62例为早期微泵肠内营养组.两组病例胎龄、入院体重无明显差异,围手术期均常规行肠外营养.早期微泵肠内营养组术后3d微泵微量输注法给予深度水解奶和益生菌,并逐步增量过渡为经口全喂养.常规治疗组术后7d开始经鼻-胃管喂养,逐步增量并过渡至经口全喂养.结果 早期微泵肠内营养组治愈59例,死亡3例,病死率为4.8%,存活儿体重增加52例,不变5例,平均体重增加(0.11±0.06)kg.常规治疗组治愈47例,死亡3例,病死率为6%,存活儿体重均下降,平均体重降低(0.05±0.04)kg.两组呼吸机辅助时间、住院天数、首次排便时间、入/出院体重变化经t检验及卡方检验,差异有统计学意义(P<0.05);病死率和吻合口瘘发生率差异没有统计学意义(P>0.05).结论 新生儿食管闭锁术后早期微泵肠内营养输注法可有效改善患儿的营养风险,缩短住院时间和减少经济花费,而病死率和吻合口瘘发生率无明显变化.
目的 探討早期微泵腸內營養輸註法在新生兒食管閉鎖治療中的必要性及對預後的影響.方法 迴顧性分析1999年4月至2012年4月收治的新生兒Ⅲ型食管閉鎖112例的臨床資料.112例均採用食道一期吻閤術.其中,1999-2006年的50例為常規治療組,2006-2012年的62例為早期微泵腸內營養組.兩組病例胎齡、入院體重無明顯差異,圍手術期均常規行腸外營養.早期微泵腸內營養組術後3d微泵微量輸註法給予深度水解奶和益生菌,併逐步增量過渡為經口全餵養.常規治療組術後7d開始經鼻-胃管餵養,逐步增量併過渡至經口全餵養.結果 早期微泵腸內營養組治愈59例,死亡3例,病死率為4.8%,存活兒體重增加52例,不變5例,平均體重增加(0.11±0.06)kg.常規治療組治愈47例,死亡3例,病死率為6%,存活兒體重均下降,平均體重降低(0.05±0.04)kg.兩組呼吸機輔助時間、住院天數、首次排便時間、入/齣院體重變化經t檢驗及卡方檢驗,差異有統計學意義(P<0.05);病死率和吻閤口瘺髮生率差異沒有統計學意義(P>0.05).結論 新生兒食管閉鎖術後早期微泵腸內營養輸註法可有效改善患兒的營養風險,縮短住院時間和減少經濟花費,而病死率和吻閤口瘺髮生率無明顯變化.
목적 탐토조기미빙장내영양수주법재신생인식관폐쇄치료중적필요성급대예후적영향.방법 회고성분석1999년4월지2012년4월수치적신생인Ⅲ형식관폐쇄112례적림상자료.112례균채용식도일기문합술.기중,1999-2006년적50례위상규치료조,2006-2012년적62례위조기미빙장내영양조.량조병례태령、입원체중무명현차이,위수술기균상규행장외영양.조기미빙장내영양조술후3d미빙미량수주법급여심도수해내화익생균,병축보증량과도위경구전위양.상규치료조술후7d개시경비-위관위양,축보증량병과도지경구전위양.결과 조기미빙장내영양조치유59례,사망3례,병사솔위4.8%,존활인체중증가52례,불변5례,평균체중증가(0.11±0.06)kg.상규치료조치유47례,사망3례,병사솔위6%,존활인체중균하강,평균체중강저(0.05±0.04)kg.량조호흡궤보조시간、주원천수、수차배편시간、입/출원체중변화경t검험급잡방검험,차이유통계학의의(P<0.05);병사솔화문합구루발생솔차이몰유통계학의의(P>0.05).결론 신생인식관폐쇄술후조기미빙장내영양수주법가유효개선환인적영양풍험,축단주원시간화감소경제화비,이병사솔화문합구루발생솔무명현변화.
Objective To evaluate the effects of early enteral nutrition infusion micropump supports during peri-operation in the treatment of neonate esophageal atresia.Methods Retrospective analyses were performed for 112 cases of newborn esophageal atresia between April 1999 and April 2012.Fifty patients between 1999-2006 received conventional therapy while 62 patients after 2006 had early enteral nutrition infusion micropump supports during peri-operation.The gestational age and admission weight had no significant inter-group difference.Early enteral nutrition infusion micropump support group received enteral nutrition after 3 days while control group had enteral nutrition after 7 days.Both groups are received basic supports during peri-operation.Results In early enteral nutrition infusion micropump support group,59 cases were cured and 3 died with a mortality rate of 4.8%.For cured children,their average weight increased (0.11 ± 0.06) kg,52 cases gained weight and 5 cases had no change in weight; in control group,47 cases were cured and 3 died with a mortality rate of 6%.For cured cases,their average weight decreased (0.05 ± 0.04) kg.Significant inter-group differences existed in ventilator time,days of hospitalization and weight change (P<0.05).But mortality rate and anastomotic leak showed no inter-group difference (P>0.05).Conclusions Early enteral nutrition infusion micropump supports can significantly reduce the nutrition risks of neonate esophageal atresia,shorter in-hospital stays,reduce economic costs and improve prognosis.