手术治疗新生儿坏死性小肠结肠炎208例临床分析与体会  

Surgical treatment of neonatal necrotizing enterocolitis:a clinical analysis of 208 cases

作　　者：毛建雄[1] 肖东[1] 罗燕[1] 张翅[1] 陈刚 王智勇[1] 任峰 MAO Jian-xiong;XIAO Dong;LUO Yan;ZHANG Chi;CHEN Gang;WANG Zhi-yong;REN Feng(Shenzhen Children Hospital,Surgery Depart 518026)

机构地区：[1]深圳市儿童医院普外一科,518026

出　　处：《中国优生与遗传杂志》2018年第7期84-86,100,共4页Chinese Journal of Birth Health & Heredity

基　　金：深圳市科技计划项目;编号:JCYJ20170303160036705

摘　　要：目的总结手术治疗的208例新生儿坏死性小肠结肠炎病例的特。方法回顾近12年我院手术治疗的新生儿坏死性小肠结肠炎的病例,统计208例患儿的胎龄、体重、发病日龄等一般情况,并根据术中探查情况统计肠坏死部位及术式,对所统计的数据进行总结分析。结果 208例手术患儿中,早产儿占64.9%,低出生体重儿占66.3%。出现肠坏死194例(93.3%);未发生肠坏死14例(6.7%)。坏死肠管主要分布于回盲部周围,其中位于回肠及末端98例(47.1%);升结肠18例(8.7%);回肠末端及回盲部或升结肠17例(8.2%);术式选择上,肠造瘘146例(70.2%),肠吻合43例(20.7%),肠腔减压19例(9.1%),腹腔引流168例(80.8%)。结论新生儿坏死性小肠结肠炎多发于早产儿和低出生体重儿,肠坏死部位以回肠末端及升结肠近端最常见。坏死肠管切除及肠造瘘是主要的手术方式,对于一般状态良好、坏死肠管局限、腹腔感染轻度的患儿则可行坏死肠管切除及肠吻合术。Objective：To summarize the characteristics of 208 cases of neonatal necrotizing enterocolitis treated by operation.Methods：Retrospective nearly 12 years in our hospital cases of surgical treatment of neonatal necrotizing enterocolitis,statistics,208 cases of gestational age,weight,age,etc. In general,according to statistical bowel necrosis area of intraoperative exploration situation and operation,to summarize the data by statistical analysis. Results：Among the 208 surgical children,64.9 percent were preterm infants and 66.3 percent were low birth weight. There were 194 cases of intestinal necrosis（93.3%）. No intestinal necrosis occurred in 14 cases（6.7%）. The necrotic bowel was mainly distributed around the echo chamber,in which 98 cases（47.1%）were located in the ileum and the end. 18 cases of ascending colon（8.7%）;17 cases（8.2%）of the ileum terminal and back blind or ascending colon;There were 146 cases of enterostomy（70.2%）,43 cases of intestinal anastomosis（20.7%）,19 cases of intestinal decompression（9.1%）,and 168 cases of abdominal drainage（80.8%）. Conclusion：Neonatal necrotizing enterocolitis is frequently found in premature and low birth weight,and intestinal necrosis is most common in the terminal and ascending colon. Necrotic bowel resection and intestinal fistula are the major surgical methods. For children with good general condition,necrotic intestinal tract,and mild abdominal infection,necrotic bowel resection and enterostomy are feasible.

关 键 词：新生儿坏死性小肠结肠炎 NEC 肠坏死 手术 肠造瘘 

分 类 号：R722.1[医药卫生—儿科]