Du Jingbin,Chen Yongwei,Guo Weihong,et al.Retrospectivestudy of indications for surgical intervention inneonatal necrotizingenterocolitis[J].Journal of Clinical Pediatric Surgery,,18():368-371.[doi:10.3969/j.issn.1671-6353.2019.05.006]
Retrospectivestudy of indications for surgical intervention inneonatal necrotizingenterocolitis
- Keywords:
- Enterocolitis; Necrotizing/SU; Infant; Newborn; Retrospective Studies
- CLC:
- R722.1;R574.62
- Abstract:
- Objective To explore the effects of different surgical intervention indications on the prognosis of neonatal necrotizing enterocolitis (NEC). Methods From January 2006 to January 2016, retrospective analysis was performed for clinical data of 340 NEC children according to the changes of surgical indications of NEC. Absolute surgical indications in early group (from January 2006 to January 2011) and absolute and relative surgical indications in late group (from January 2011 to January 2016) were designated according to different treatment methods and Bell staging The early and late groups were split into different subgroups. And the differences in surgical and survival rates were compared before and after the changes of surgical indications. Results There were 96 cases in middle/early stage and 244 cases in late stage. The operative rate was 17.7% in early group and 22.5% in late group (P>0.05). The overall survival rate was 75.0% in pre-stage group and 86.9% in late group and overall survival rate significantly increased (P<0.05). The survival rate of operative group was 47.1% in early group and 74.5% in late group (P<0.05). The operative rate of Bell(Ⅱ) was significantly higher in late group than that in previous group (P<0.05). No significant change occurred in operative rate during Bell(Ⅲ) period (P>0.05). The survival rate after altered surgical indication showed no obvious improvements(P>0.05).Conclusion Besides pneumoperitoneum, complete intestinal obstruction, ultrasonic examination of intestinal necrosis and other absolute surgical indications, neonatologists should closely observe the disease progress during an early stage of NEC, improve the ability of comprehensive clinical judgment and individualize adjustment of surgical indications.
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Memo
收稿日期:2018-10-21。
通讯作者:陈永卫,Email:yongwei1964@126.com