经肛门引流管在回肠末端近回盲部肠吻合术中的临床应用  

Clinical application of transanal drainage tube in ileal anastomosis near ileocecal end

作　　者：舒芳 曾珊 肖赟 吴书清 钟斌 张鹏 刘传荣 SHU Fang;ZENG Shan;XIAO Yun;WU Shuqing;ZHONG Bin;ZHANG Peng;LIU Chuanrong(Department of Pediatric surgery,Ganzhou Maternal and Child Health Care Hospital,Ganzhou,Jiangxi,341000,China;Department of Neonatology,Ganzhou Maternal and Child Health Care Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市妇幼保健院儿外科,江西赣州341000 [2]赣州市妇幼保健院新生儿科,江西赣州34100

出　　处：《当代医学》2024年第11期137-139,共3页Contemporary Medicine

基　　金：赣州市指导性科技计划项目(GZ2021ZSF309)。

摘　　要：目的分析经肛门引流管在回肠末端近回盲部肠吻合术中的临床应用。方法回顾分析2015年1月至2021年12月赣州市妇幼保健院收治的60例新生儿坏死性小肠结肠炎造瘘后远端回肠狭窄患儿的临床资料。在距离回肠末端5 cm以内的回肠吻合手术中,根据手术方式的不同分为对照组与观察组,每组30例。对照组采取保留回盲部直接行回肠吻合术,观察组采取回肠末端近回盲部肠吻合术治疗。比较两组临床病情控制优良率、手术时间、术后开始肠内营养时间、住院时间及并发症发生率。结果观察组临床病情控制优良率高于对照组,差异有统计学意义(P<0.05)。两组手术时间比较差异无统计学意义;观察组术后开始肠内营养时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论回肠末端近回盲部肠吻合术治疗新生儿坏死性小肠结肠炎造瘘后远端回肠狭窄的效果更佳,在距离回肠末端5 cm以内的回肠吻合手术中,采用经肛门引流管相对于以往保留回盲部一期行回肠吻合手术,病情控制较好,可缩短术后开始肠内营养时间、住院时间,且术后相关并发症少,值得推广应用。Objective To analyze clinical application of transanal drainage tube in ileal anastomosis near ileocecal end.Methods The clinical data of 60 children with distal ileal stricture after neonatal necrotizing enterocolitis fistula from January 2015 to December 2021 in Ganzhou Maternal and Child Health Hospital were retrospectively analyzed.In the ileal anastomosis operation within 5 cm from the end of the ileum,the patients were divided into the control group and the observation group according to the different operation methods,with 30 cases in each group.The control group underwent ileal anastomosis directly with the ileocecal part reserved,and the observation group was treated with ileal anastomosis near ileocecal end.The excellent and good rate of clinical disease control,operation time,postoperative enteral nutrition time,hospitalization time,and the total incidence of complications were compared between the two groups.Results The good and good rate of clinical disease control in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in operation time between the two groups;the time of postoperative enteral nutrition and hospitalization in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of ileal anastomosis near ileocecal end in the treatment of distal ileal stenosis after neonatal necrotizing enterocolitis is better,the use of transanal drainage tube in the ileal anastomosis operation within 5 cm from the end of the ileum is better controlled than that of the previous one-stage ileostomy operation with the ileocecal part reserved,which can shorten the time of postoperative enteral nutrition and hospitalization,and the postoperative complications are less,is wort

关 键 词：新生儿坏死性小肠结肠炎 造瘘后远端回肠狭窄 回肠末端近回盲部肠吻合术 肛门引流管 

分 类 号：R779.6[医药卫生—眼科]