新生儿坏死性小肠结肠炎II-B期的外科治疗策略

A. Vakhidov, D. Mamarasulova, Akmal Khaitov
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引用次数: 0

摘要

分析2018年至2022年收治的18例II-B期NEC新生儿的手术治疗结果。目的:分析现代技术在新生儿II-B期坏死性小肠结肠炎手术治疗中的应用效果。共行诊断性腹腔镜检查18例,其中中转开腹4例。在14例患者中,治疗性腹腔镜下采用小切口视频评估完成DL,其中8例患者采用端对端吻合术切除小肠坏死部分。6例采用小切口肠造口术。相比之下,采用视频评估的腹腔镜手术后死亡率为1 / 14,而采用传统手术干预后死亡率为25%,为1 / 4。基于手术阶段DL的结果,可以建立进一步的根治性手术治疗策略,将其转化为治疗性治疗的可能性最小化术中创伤,这对患者的术后生存有积极的影响。
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Tactics of surgical treatment in necrotising enterocolitis stage II-B in newborn
An analysis was made of the results of surgical treatment of 18 newborns with a diagnosis of stage II-B NEC, admitted in the period from 2018 to 2022. The aim of the work: to analyze the results of surgical treatment for stage II-B necrotizing enterocolitis in newborns using modern technologies. A total of 18 diagnostic laparoscopies (DL) were performed, of which 4 cases were converted - laparotomy. In 14 patients cases, DL was completed by therapeutic laparoscopy using minilaparotomy with video-assessment, including 8 patients, resection of the necrotic portion of the intestine was performed with end-to-end anastomosis. In 6 cases, an intestinal stoma was applied through a minilaparotomy.In comparison, after laparoscopic operations with video assessment, mortality was observed of cases 1 patient out of 14, after traditional surgical interventions, mortality was in 25% of cases 1 patient out of 4. Based on the results of DL at the surgical stage of NEC, it is possible to build further tactics of radical surgical treatment, the possibility of transforming it into a therapeutic one minimizes intraoperative trauma, which positively affects the postoperative survival of patients.
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