新生儿坏死性小肠结肠炎外科手术时机和术式的决策分析.docVIP

新生儿坏死性小肠结肠炎外科手术时机和术式的决策分析 　　[摘要] 目的 分析新生儿坏死性小肠结肠炎（NEC）外科手术时机和术式。 方法 利用数字随机抽选的方法，从该院2014年2月―2015年2月接收治疗的坏死性小肠结肠炎患儿当中，随机选择50例展开研究，男性患儿30例，女性患儿20例；患儿年龄为3～27 d，分析其反应肠坏死的指标及代谢紊乱频数对于患儿手术的干预时机。 结果 该次研究的50例坏死性小肠结肠炎患儿， 有10例接受了外科治疗，其中5例患儿发生气腹属于晚期手术；有5例患儿未发生肠穿孔，单有肠坏死属于早期手术，晚期手术的病死率为20.0%，并发症的发生率为60.0%；早期手术死亡率为0，并发症的发生率是20.0%，早期手术与晚期手术的结果对比差异有统计学意义（P0.05）。结论 儿科临床中，可以根据新生儿坏死性小肠结肠炎患儿的12个反应肠坏死指标以及反映代谢紊乱的7项频数，为患儿提供最佳的手术时机以及手术方式，应用价值较高，值得积极推广与运用。 　　[关键词] 新生儿；坏死性小肠结肠炎；外科手术；时机；决策分析 　　[中图分类号] R722.1 [文献标识码] A [文章编号] 1674-0742（2016）10（c）-0092-03 　　[Abstract] Objective To analyze the surgical timing and surgical procedures of neonatal necrotizing NEC. Methods Using the method of digital randomly selected from our hospital in February 2014 to February 2015 in receiving treatment of necrotizing enterocolitis， randomly select 50 cases study， 30 cases of male children， women with 20 cases； Children aged 3～27 d， analysis the reaction index of intestinal necrosis and metabolic disturbance frequency for surgical intervention for children. Results The study of 50 cases of children with necrotizing enterocolitis， 10 cases received surgical treatment， of which 5 cases underwent pneumoperitoneum belonged to the late operation； Five cases， there was no intestinal perforation， single belongs to early surgery have bowel necrosis， late operation case fatality rate of 20.0%， the incidence of complications was 60.0%； Early surgical mortality was 0， the incidence of complications was 20.0%， early surgery， compared with the results of the late surgery has significant difference was statistically significant （P 0.05）. Conclusion Pediatric clinical， can according to neonatal necrotizing enterocolitis with 12 indexes of bowel necrosis reaction and reflection of the metabolic disorder of seven frequency， to provide children with the best operation time and operation method， high application value， to actively promote and use. 　　[Key words] Newborn； Necrotizing； Surgical operation； Opportunity； Decisi