Zhao Xiaoxia,Wang Jiali,Hu Shuqi,et al.Managements of ultra-short bowel syndrome in infants[J].Journal of Clinical Pediatric Surgery,2023,22(12):1146-1150.[doi:10.3760/cma.j.cn101785-202209023-010]
儿童超短肠综合征治疗分析
- Title:
- Managements of ultra-short bowel syndrome in infants
- Keywords:
- Short Bowel Syndrome; Ultra-short Bowel Syndrome; Enteral Nutrition; Parenteral Nutrition; Postoperative Complications; Therapy; Prognosis; Child
- 摘要:
- 目的 总结超短肠综合征(ultra-short bowel syndrome,USBS)的治疗经验,并分析其预后。方法 回顾性分析2015年1月至2021年2月浙江大学医学院附属儿童医院新生儿外科收治的24例超短肠综合征患儿临床资料,总结其临床特点、治疗经过及预后情况。结果 24例患儿中,男17例,女7例;早产儿20例,足月儿4例;胎龄26~39+5周;出生体重720~3 600 g。7例暂时性USBS患儿于造口关闭后行短期营养治疗痊愈;17例非暂时性USBS患儿中,7例脱离肠外营养达到肠适应,5例放弃治疗(出院后死亡),5例需继续肠外营养支持治疗。19例存活USBS患儿治疗过程中,发生静脉营养相关性胆汁淤积9例,导管感染9例,获得性锌缺乏皮炎3例,维生素D缺乏6例,代谢性骨病2例;均经对症治疗后好转。结论 超短肠综合征治疗困难,并发症多,经合理治疗,部分患儿可脱离肠外营养达到肠适应。
- Abstract:
- Objective To explore the treatments and outcomes of infants with ultra-short bowel syndrome (USBS).Methods From January 2015 to February 2021,retrospective review was conducted for 24 USBS infants.Clinical characteristics,treatments and outcomes were recorded.There were 17 boys and 7 girls with a gestational age of (26-39+5) week and a range of birth weight (720-3 600) gram.The infants were premature (n=20) and full-term (n=4).Results Among them,7 infants of temporary USBS were discharged upon completing short-term nutritional therapy after closing stoma; 7/17 infants of non-temporary USBS were weaned off parenteral nutrition to achieve intestinal adaptation; 5/17 relinquished further treatments during operation; 5/17 required continued parenteral nutrition.Among 19 survivors,there were intravenous nutrition-related cholestasis (n=9),catheter infection (n=9),acquired zinc deficiency dermatitis (n=3),vitamin D deficiency (n=6) and metabolic bone disease (n=2).All symptoms improved after symptomatic measures.Conclusions It is rather troublesome to manage USBS children and there are numerous complications.After proper treatments,some infants may finally achieve intestinal adaptation without parenteral nutrition
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备注/Memo
收稿日期:2023-9-16。
基金项目:浙江省自然科学基金(LY21H150005)
通讯作者:钭金法,Email:toujinfa@zju.edu.cn