极低出生体重儿粪相关肠梗阻的积极灌肠和手术治疗。

IF 1.6 3区 医学 Q2 PEDIATRICS
Kenji Santo, Yuichi Takama, Marie Todo, Hisashi Yagi, Shuto Ikeda, Yuko Tanaka, Hiroyuki Ichiba, Masafumi Kamiyama
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引用次数: 0

摘要

目的:探讨一种积极治疗策略对极低出生体重儿(ELBWIs)胎粪相关性肠梗阻(MRI)的有效性。方法:自2018年4月以来,我们实施了一项新的方案,包括早期胃grafin注射,积极灌肠治疗和早期无穿孔手术(ES)。在我院过去15年治疗的362例elbwi患者中,有91例MRI纳入本研究。我们比较了“老年”组的患者人口统计、治疗细节和结果(0,n = 56;2018年3月前治疗)和“New”组(N, N = 35;2018年4月以后治疗)。结果:O组穿孔率较高,为21.4%;12/56)高于N组(2.9%,1/35)(p = 0.014)。0组和N组手术率分别为21.4%(12/56)和14.3%(5/35),差异有统计学意义(p = 0.581), ES率分别为0%(0/56)和11.8%(4/35),差异有统计学意义(p = 0.02)。N组总生存率(100%,35/35)显著高于O组(87.5%,49/56)(p = 0.041)。在O组中,所有7例死亡均与穿孔有关。结论:我们积极的MRI治疗与减少穿孔率和改善生存结果相关,证明了其有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Aggressive enema and surgery for meconium-related ileus in extremely low-birth-weight infants.

Purpose: To investigate the effectiveness of an aggressive treatment strategy for meconium-related ileus (MRI) in extremely low birth weight infants (ELBWIs).

Methods: Since April 2018, we have implemented a novel protocol, incorporating early Gastrografin injection, aggressive enema therapy, and early surgery without perforation (ES). Among 362 ELBWIs treated at our institute over the past 15 years, 91 with MRI were included in this study. We compared patient demographics, treatment details, and outcomes between the "Old" group (O, n = 56; treated before March 2018) and the "New" group (N, n = 35; treated after April 2018).

Results: The O group showed higher perforation rates (21.4%; 12/56) than those of the N group (2.9%, 1/35) (p = 0.014). The surgical rates were 21.4% (12/56) and 14.3% (5/35) in the O and N groups, respectively (p = 0.581), while the ES rates were 0% (0/56) and 11.8% (4/35), respectively (p = 0.02). The N group had a significantly higher overall survival rate (100%, 35/35) than the O group (87.5%, 49/56) (p = 0.041). In the O group, all seven deaths were related to perforation.

Conclusions: Our aggressive MRI treatment was associated with reduced perforation rates and improved survival outcomes, demonstrating its effectiveness.

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来源期刊
CiteScore
3.00
自引率
5.60%
发文量
215
审稿时长
3-6 weeks
期刊介绍: Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor
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