新生儿坏死性小肠结肠炎患儿术中补液量对术后转归的影响  

Influence of intraoperative fluid replacement on postoperative outcomes in pediatric patients with neonatal necrotizing enterocolitis

作　　者：谢欣 郭春宝[1] 邓春[1] Xie Xin;Guo Chunbao;Deng Chun(Department of Neonatal Diagnosis and Treatment Center,Children’s Hospital of Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics)

机构地区：[1]重庆医科大学附属儿童医院新生儿诊治中心、儿童发育疾病研究教育部重点实验室、国家儿童健康与疾病临床医学研究中心、儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,重庆400014

出　　处：《重庆医科大学学报》2020年第10期1448-1453,共6页Journal of Chongqing Medical University

摘　　要：目的:评估新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)手术患者术中晶体输注量与术后转归的关系。方法:回顾性分析2012年1月至2018年9月在重庆医科大学附属儿童医院确诊NEC并接受手术的172例患儿的临床资料,以校正术中输入晶体量后中位数为标准,将患儿分为低晶体组[<25.89 mL/(kg·h)]与高晶体组[>25.89 m L/(kg·h)],监测术后开奶时间、首次排便时间、是否发生并发症、重症监护治疗时间及术后住院时间、死亡、术后90 d内不能完全肠内营养等术后指标,进行比较分析。结果:单因素分析结果显示,2组患儿术后并发症发生率差异有统计学意义(P<0.05)。将术后单因素分析P<0.05的变量纳入logistic向后逐步回归分析得到,输液量(OR=0.955,95%CI=0.914~0.997,P=0.036)是术后并发症发生的保护因素。结论:增加术中输液量可降低术后并发症发生率。Objective:To evaluate the relationship between intraoperative crystalloid administration and postoperative outcomes in pediatric patients with neonatal necrotizing enterocolitis(NEC). Methods:A total of 172 NEC patients undergoing surgery from January2012 to September 2018 in our hospital were retrospectively analyzed and were divided into the low crystalloid group[<25.89 mL/(kg·h)]and the high crystalloid group[>25.89 mL/(kg·h)] by taking median after correcting input crystalloid amount as standard. First time to enteral feeds,first defecation,the incidence of complications,the postoperative length of NICU or ICU stay,postoperative death and incomplete enteral nutrition within 90 days after surgery were monitored and compared. Results:The univariate analysis showed that the incidence of postoperative complications was significantly different in two groups(P<0.05). Variables with P<0.05 in univariate analysis were included in stepwise backward logistic regression analysis and it was identified that crystalloid administration was an independent protective factor of postoperative complications(OR=0.955,95%CI=0.914-0.997,P=0.036). Conclusion:The intraoperative crystalloid administration can reduce the risk of postoperative complications.

关 键 词：晶体输液量 术后住院时间 腹部手术 术中失血量 

分 类 号：R726.1[医药卫生—儿科]