Huang Yuanyuan,Ren Hongxia.Risk factors of postoperative Hirschsprung-associated enterocolitis[J].Journal of Clinical Pediatric Surgery,2024,(05):430-433.[doi:10.3760/cma.j.cn101785-202206036-006]
先天性巨结肠手术后小肠结肠炎的危险因素分析
- Title:
- Risk factors of postoperative Hirschsprung-associated enterocolitis
- Keywords:
- Necrotizing Enterocolitis; Hirschsprung Disease; Risk Factors; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨先天性巨结肠手术后小肠结肠炎(Hirschsprung-associated enterocolitis,HAEC)的相关危险因素。 方法 回顾性分析山西省儿童医院2011年1月至2021年6月收治的先天性巨结肠(Hirschsprung’s disease,HSCR)患儿临床资料,将术后发生HAEC者归入术后HAEC组,未发生HAEC者归入无术后HAEC组;从患儿性别、行根治手术年龄、合并小细胞低色素性贫血、术前HAEC史、术前造瘘史、病理分型、合并低白蛋白血症等方面分析影响先天性巨结肠手术后HAEC的危险因素。 结果 共纳入313例HSCR患儿,术后1年内发生HAEC 47例(术后HAEC组),未发生HAEC 266例(无术后HAEC组)。术后HAEC组与无术后HAEC组患儿性别、行根治手术年龄差异无统计学意义(P＞0.05),合并小细胞低色素性贫血(28/47比94/266)、术前HAEC史(21/47比60/266)、术前造瘘史(11/47比27/266)、长段型及全结肠型HSCR(16/47比45/266)、合并低白蛋白血症(38/47比176/266)差异有统计学意义(P＜0.05)。Logistic回归分析结果显示,合并小细胞低色素性贫血(OR=2.522,95%CI:1.301~4.887)、术前合并HAEC(OR=2.812,95%CI:1.415~5.589)是先天性巨结肠手术后发生HAEC的危险因素(P＜0.05)。 结论 合并小细胞低色素性贫血、术前合并HAEC是先天性巨结肠手术后HAEC的危险因素;重视术后HAEC发生的高危因素,可以有效减少HSCR根治术后严重并发症,提高患儿生存质量。
- Abstract:
- Objective To explore the risk factors of postoperative Hirschsprung-associated enterocolitis (HAEC) within 1 year.Methods From January 2011 to June 2021,the relevant clinical data were retrospectively reviewed for 313 children with Hirschsprung’s disease (HSCR).They were assigned into two groups of postoperative HAEC (n=47) and no postoperative HAEC (n=266).The risk factors of postoperative HAEC included patient gender,age of radical operation,microcytic hypochromic anemia,preoperative HAEC history,preoperative colostomy,pathological classification and hypoalbuminemia.Results Patient gender or age of radical operation showed no difference of statistical significance (P>0.05).And microcytic hypochromic anemia [(59.6%,28/47) vs.(35.3%,94/266)],preoperative HAEC [(44.7%,21/47) vs.(22.6%,60/266)],preoperative colostomy [(23.4%,11/47)vs.(10.2%,27/266)],long segment or total colonic HSCR [(34.0%,16/47)vs.(16.9%,45/266)]and hypoalbuminemia [(80.9%,38/47) vs.(66.2%,176/266)]revealed statistically significant differences (P<0.05).Multiple Logistic regression analysis indicated that microcytic hypochromic anemia (OR=2.522,95%CI:1.301-4.887) and preoperative HAEC(OR=2.812,95%CI:1.415-5.589) were correlated with postoperative HAEC.Conclusions Complication of microcytic hypochromic anemia and preoperative HAEC are the risk factors of postoperative HAEC.Focusing upon the risk factors of postoperative HAEC can effectively lower the most serious complications of HSCR after radical operation and improve the quality-of-life of children.
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备注/Memo
收稿日期:2022-06-15。
基金项目:山西省儿童医院院级项目(2023002)
通讯作者:任红霞,Email:renhongxia100@sina.com