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先天性肠旋转不良术后肠内营养耐受影响因素分析 预览

Related factors influencing the enteral nutrition tolerance in neonates with congenital intestinal malrotation after operation
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摘要 目的探讨影响先天性肠旋转不良患儿术后肠内营养耐受的相关因素。方法回顾性分析120例新生儿先天性肠旋转不良进行手术患儿的临床资料,病程中根据患儿临床表现、术后早期48h内开始接受肠内营养(enteralnutrition,EN)治疗,根据患儿临床表现为耐受组(n=56)和不耐受组(n=64),比较营养耐受和不耐受患者的临床资料,分析营养不耐受及全肠内营养的影响因素。结果耐受组腹膜炎、乳糜腹、肠坏死发生率显著低于不耐受组,首次肠内营养时间、空肠营养管放置率显著高于不耐受组,差异有统计学意义(P<0.05),腹膜炎、乳糜腹、肠坏死、放置空肠营养管、首次肠内营养时间与新生儿先天性肠旋转不良术后全肠内影响恢复有相关性(R值分别为0.353、0.478、0.455、-0.523、-0.392,P<0.05)。多元线性回归分析发现,腹膜炎、乳糜腹、肠坏死、留置空肠营养管、首次肠内营养时间与新生儿先天性肠旋转不良术后营养耐受及全肠内营养恢复存在相关性(P<0.05)。结论腹膜炎、肠坏死、乳糜腹等因素可显著影响先天性肠旋转不良患儿术后肠内营养耐受,术中采取留置空肠营养管、首次EN时间术后早期EN等措施可以改善肠内营养耐受尽快到达全肠内营养。 Objective To investigate the related factors influencing the enteral nutrition tolerance in neonates with congenital intestinal malrotation after operation.Methods The clinical data of 120 neonates with congenital intestinal malrotation who were treated by surgery in our hospital from January 2014 to June 2016 were retrospectively analyzed.According to the clinical manifestations of the patients and the beginning time of enteral nutrition(EN) treatment within 48 hours after operation,the patients were divided into nutrition tolerance group(n=56) and nutrition intolerance group(n=64).The clinical data were observed and compared between the two groups,moreover,the influencing factors of nutritional intolerance and total enteral nutrition were analyzed.Results The incidence rates of peritonitis,chyloperitoneum and intestinal necrosis in nutrition tolerance group were significantly lower than those in nutrition intolerance group,however,the first enteral nutrition time and the placement rate of jejunal nutrition tube in nutrition tolerance group were significantly higher than those in nutrition intolerance group(P<0.05).The peritonitis,chyloperitoneum,intestinal necrosis,jejunal nutrition tube placement,the first enteral nutrition time and total enteral nutrition after operation were correlated with the effects infleuncing the full enteral nutrition recovery(r=0.353,0.478,0.455,0.523,0.392,respectively,P<0.05).The multiple linear regression analysis showed that peritonitis,intestinal necrosis,chylous ascites,nasojejunal feeding tubes and first enteral nutrition time were signicantly correlated with the nutrition tolerance and full enteral nutrition recovery in neonates with congenital intestinal malrotation after operation.Conclusion The peritonitis,intestinal necrosis,chylous ascites may significantly affect nutrition tolerance in neonates with congenital intestinal malrotation after operation,and the intraoperative jejunal nutrition tube placement and first enteral nutrition time after operation may improve enteral
作者 马颖钰 平赛 牛会忠 张鹏举 董彦清 刘峰 任慧 王丽亚 MA Yingyu;PING Sai;NIU Huizhong(Department of General Surgery,Hebei Provincial Children’s Hospital Affiliated to Hebei Medical University,Hebei,Shijiazhuang 050031,China)
出处 《河北医药》 CAS 2019年第14期2117-2121,共5页 Hebei Medical Journal
基金 河北省医学研究重点课题计划(编号:20180626).
关键词 先天性肠旋转不良 肠内营养 营养耐受 影响因素 congenital intestinal malrotation enteral nutrition nutritional tolerance influencing factor
作者简介 通讯作者:牛会忠,050031,河北医科大学附属河北省儿童医院普外科;E-mail:nrlnhz@163.com.
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