Li Ming,Xie Ting,Zou Chanjuan,et al.Application value of nasal enteral tube continuous low-pressures suction for high jejunal atresia[J].Journal of Clinical Pediatric Surgery,2025,(12):1149-1152.[doi:10.3760/cma.j.cn101785-202509013-010]
高位空肠闭锁手术后鼻空肠管持续低负压吸引的应用价值探讨
- Title:
- Application value of nasal enteral tube continuous low-pressures suction for high jejunal atresia
- Keywords:
- Intestinal Atresia; Surgical Procedures; Operative; Enteral Nutrition; Cannula; Nasal Enteral Tube; Treatment Outcome
- 摘要:
- 目的 探讨鼻空肠管持续低负压吸引(nasal enteral tube continuous low-pressure suction,NETCLPS)在高位空肠闭锁手术后的应用价值。方法 回顾性分析湖南省儿童医院胎儿与新生儿外科于2024年7月至2025年6月收治的6例高位空肠闭锁手术后行经鼻空肠管持续负压吸引患儿临床资料,收集性别、孕周、出生体重、合并畸形、术后开奶时间、住院时长、出院时体重、闭锁小肠近远端长度及直径、手术方式。结果 6例均为早产儿,男性1例、女性5例;3例为低出生体重儿,1例合并室间隔缺损。5例于产前发现十二指肠扩张,闭锁近端距屈氏韧带4~10 cm,肠管直径2.5~4.0 cm;闭锁远端距回盲部85~175 cm,肠管直径0.4~0.6 cm。Ⅲa型3例,Ⅲb型2例,Ⅳ型I例。6例均行腹腔镜探查、开腹手术下空肠吻合术(2例Ⅲb型病例加行肠系膜整形,1例Ⅳ型病例行3处肠吻合),并放置鼻空肠管至吻合口近端。肠内营养开始时间为术后7~11 d,恢复完全肠内营养时间为35~85 d,均痊愈出院,体重增长950~2 100 g,无一例出现并发症。结论 高位空肠闭锁手术后鼻空肠管持续低负压吸引可促进肠功能恢复,取得良好治疗效果,有一定临床推广价值。
- Abstract:
- Objective To explore the application value of nasal enteral tube continuous low-pressure suction (NETCLPS) for high jejunal atresia. Methods From July 2024 to June 2025,retrospective analysis was performed for the relevant clinical data of 6 preterm infants with high jejunal atresia admitted with continuous negative pressure suction using a nasojejunal tube.The following parameters of gender,gestational age,birth weight,concurrent malformations,postoperative milk opening time,duration of hospitalization,weight at discharge,length/diameter of mesiodistal atresia of small intestine and surgical approaches were recorded. Results There were 1 boy and 5 girls.There were low birth weight (n=3) and complicated by ventricular septal defect (n=1).Duodenal dilation (n=5) was found with proximal end of atresia (4-10) cm from flex ligament and a diameter of intestinal tract (2.5-4.0) cm and distal end of atresia (85-175) cm from ileocecal region and a diameter of intestinal tract (0.4-0.6) cm.The clinical types were Ⅲ.a (n=3),Ⅲ.b (n=2) and Ⅳ (n=1).Laparoscopic exploration and jejunal anastomosis were performed along with mesenteroplasty (Ⅲ.b,n=2) and 3-part intestinal anastomosis (Ⅳ.n=1).A nasojejunal tube was placed to proximal anastomosis of anastomosis.Enteral nutrition started at Day (7-11) day post-operation.Time to return to full enteral nutrition resumed at Day (35-85) and weight gain was (950-2100) kg.All of them were cured and discharged from without complications. Conclusions Nasal enteral tube continuous low-pressure suction can achieve excellent outcomes without related complications.Both safe and efficacious,it is worthy of wider clinical promotion.
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备注/Memo
收稿日期:2025-9-6。
基金项目:湖南省卫生健康委科研计划(B202306028241)
通讯作者:周崇高,Email:zhouchonggao@sina.com