Li Yuan,Li Tianyu,Su Pengjun,et al.Clinical characteristics of infants with meconium peritonitis diagnosed prenatally versus postnatally and analysis of factors affecting postoperative intestinal function recovery[J].Journal of Clinical Pediatric Surgery,,():1134-1139.[doi:10.3760/cma.j.cn101785-20251215-00118-008]
Clinical characteristics of infants with meconium peritonitis diagnosed prenatally versus postnatally and analysis of factors affecting postoperative intestinal function recovery
- Keywords:
- Prenatal Diagnosis; Meconium Peritonitis; Surgical Procedures; Operative; Intestinal Rehabilitation; Root Cause Analysis
- Abstract:
- Objective To investigate differences in clinical characteristics between infants with meconium peritonitis (MP) diagnosed prenatally and those diagnosed postnatally,and to analyze the impact of prenatal diagnosis and other related factors on postoperative intestinal function recovery in infants with MP. Methods Clinical data of infants with MP treated at Shengjing Hospital of China Medical University from January 2015 to January 2025 were retrospectively analyzed.According to the timing of diagnosis,patients were divided into a prenatal diagnosis group and a postnatal diagnosis group.General characteristics,prematurity,clinical features,ventilator use,surgical procedures,preservation of the ileocecal valve,duration of postoperative fasting,duration of postoperative parenteral nutrition,and length of hospital stay were compared between the two groups.The effects of the above factors on postoperative intestinal function recovery were analyzed. Results Among 73 infants with MP who received standardized treatment,56 were diagnosed prenatally and 17 postnatally.In the prenatal diagnosis group,the predominant clinical subtype was the intestinal obstruction type (38 cases,67.81%),whereas in the postnatal diagnosis group,the peritonitis type predominated (10 cases,56.25%).All three asymptomatic cases were diagnosed prenatally.The distribution of clinical subtypes differed significantly between the two groups (P<0.05).The length of hospital stay was 16.0(11.0,22.5) days in the prenatal diagnosis group and 12.5(10.0,15.0) days in the postnatal diagnosis group,with a statistically significant difference (P<0.05).Among 70 infants who underwent surgery,the postoperative fasting duration and postoperative parenteral nutrition duration were 9.0 (8.0,12.0) days and 11.0(9.0,15.0) days,respectively.Infants who underwent primary intestinal anastomosis had a significantly shorter postoperative fasting duration than those who underwent enterostomy ［6.5(8.0,11.0) days vs.9.0(8.0,13.0) days,P<0.05］.Infants in whom the ileocecal valve was preserved intraoperatively had a significantly shorter duration of postoperative parenteral nutrition than those without preservation ［10.0(8.5,13.5) days vs.12.0(10.0,16.5) days,P<0.05］.Compared with the postnatal diagnosis group,the prenatal diagnosis group had a significantly longer postoperative fasting duration ［10.0(8.0,13.0) days vs.8.0 (10.0,16.5) days,P<0.05］ and a significantly longer duration of postoperative parenteral nutrition ［13.0(9.5,17.0) days vs.10.0(8.5,10.5) days,P<0.01］.Multivariate analysis showed that prenatal diagnosis was a risk factor for delayed postoperative intestinal function recovery in infants with MP (OR=0.105,95%CI:0.012-0.897,P<0.05). Conclusions Most infants with MP can be diagnosed prenatally.In prenatally diagnosed infants,the intestinal obstruction type is the predominant clinical subtype,and some prenatally diagnosed infants may present with asymptomatic MP.Prenatally diagnosed infants experience a longer duration of postoperative intestinal dysfunction than those diagnosed postnatally.Prenatal diagnosis is a risk factor for delayed postoperative intestinal function recovery in infants with MP.
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Memo
收稿日期:2025-12-15。
基金项目:辽宁省科技计划联合计划项目(辽科办发[2024]41号)
通讯作者:张志波,Email:zhangzb@sj-hospital.org