santulli肠吻合造瘘术在新生儿肠梗阻中的应用  

Application of santulli enterostomy in neonatal intestinal obstruction

作　　者：岳铭[1] 翟子绮 王冠涛 张宁[1] 杨合英[1] YUE Ming;ZHAI Ziqi;WANG Guantao;ZHANG Ning;YANG Heying(Department of Pediatric Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052;Department of Plastic Surgery, Shangqiu People′s Hospital, Shangqiu, Henan 476600)

机构地区：[1]郑州大学第一附属医院小儿外科,郑州450052 [2]永城市人民医院整形外科,河南商丘476600

出　　处：《郑州大学学报（医学版）》2020年第4期572-576,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨santulli肠吻合造瘘术在新生儿肠梗阻手术治疗中的应用价值。方法:分析2015年1月至2019年1月在郑州大学第一附属医院行肠造瘘治疗的62例新生儿的临床资料,按手术方式的不同分为两组,其中santulli组21例,均行小肠santulli肠吻合造瘘术;对照组41例,其中采用双腔造瘘术11例,单腔造瘘术30例。观察两组患儿的一般资料,并随访两组造瘘后并发症和关瘘时各临床指标的差异。结果:造瘘时手术时间两组差异无统计学意义,关瘘时santulli组小于对照组(P<0.001);造瘘时出血量两组差异无统计学意义,关瘘时santulli组小于对照组(P=0.002);造瘘后两组术后首次进食时间差异无统计学意义,关瘘后santulli组短于对照组,差异有统计学意义(P<0.001);santulli组使用肠外营养时间短于对照组(P=0.006);santulli组术后切口感染和肠梗阻发生率均低于对照组(P<0.05)。santulli组总住院日、住院次数及住院费用均低于对照组(P<0.05)。结论:santulli肠吻合造瘘术治疗新生儿肠梗阻并发症少,关瘘时间短,住院时间短,花费少,优势明显。Aim:To explore the application value of santulli enterostomy in the surgical treatment of neonatal intestinal obstruction.Methods:The clinical data of 62 newborns who underwent enterostomy in the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2019 were analyzed.They were assigned to the santulli group and the control group.The santulli group included 21 cases who underwent santulli enterostomy.The control group included 41 cases(11 cases of double-chamber enterostomy and 30 cases of single-chamber enterostomy).The general data of the two groups were observed,and the postoperative complications and clinical indexes during fistula closure were followed up.Results:There was no significant difference in operation time between the two groups during enterostomy.The operation timeof the santulli group was shorter than that of the control group during fistula closure(P<0.001).For the account of blood loss,there was no significant difference between the two groups during enterostomy,while during fistula closure,that of the santulli group was less(P=0.002).There was no significant difference in the starting time of first taking food after operation,which was shorter in the santulli group at the time of fistula closure.The duration of using parenteral nutrition in the santulli group was shorter than that in the control group(P<0.001).The incidence of postoperative wound infection and intestinal obstruction in santulli group was significantly lower than those in the control group(P<0.05).The total hospitalization days,hospitalization times and hospitalization expenses in the santulli group were less than those in the control group(P<0.05).Conclusion:Santulli enterostomy has lower rate of complications,shorter operation time at fistula closing,shorter hospitalization stay,and less cost,therefore it has obvious advantages in the treatment of neonatal intestinal obstruction.

关 键 词：新生儿 santulli肠吻合造瘘术 肠梗阻 

分 类 号：R619.9[医药卫生—外科学]