上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

先天性巨结肠小肠结肠炎反复发作危险因素分析

李玉青1，严志龙2，冯一1，潘莉雅1，谢周龙龙2，洪莉1   

  1. 上海交通大学 医学院附属上海儿童医学中心 1．临床营养科， 2．外科， 上海 200127
  • 出版日期:2016-06-28 发布日期:2016-07-25
  • 通讯作者: 洪莉, 电子信箱: lihongscmc@aliyun.com。
  • 作者简介:李玉青（1989—）， 女， 硕士生; 电子信箱: liyuqing0630@163.com。
  • 基金资助:

    上海自然科学基金（面上）项目（13ZR1426300）；上海儿童医学中心—雅培/世界健康基金会临床营养发展中心（AFINS-HOPE-2013-18）

Analysis of risk factors for recurrent Hirschsprung-associated enterocolitis

LI Yu-qing1, YAN Zhi-long2, FENG Yi1, PAN Li-ya1, XIE Zhou-long-long2, HONG Li1   

  1. 1.Department of Clinic Nutrition; 2.Department of Surgery, Shanghai Childrens Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2016-06-28 Published:2016-07-25
  • Supported by:

    Natural Science Foundation of Shanghai，13ZR1426300； The Abbott Fund Institute of Nutrition Science， AFINS-HOPE-2013-18

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摘要：

目的 探讨先天性巨结肠小肠结肠炎反复发作的非手术影响因素。方法 回顾性分析上海交通大学医学院附属上海儿童医学中心2007年1月—2014年1月收治的67例接受巨结肠根治术患儿的临床资料，将小肠结肠炎发作≥3次者纳入肠炎反复发作组，1~2次者纳入肠炎组，未发肠炎者纳入无肠炎组。分析肠炎反复发作的非手术影响因素。结果 3组间性别和根治术年龄差异均无统计学意义（P>0.05）；肠炎反复发作组病变类型、低白蛋白血症发生率与肠炎组相比差异均无统计学意义（P>0.05），但与无肠炎组比较均存在统计学差异（P>0.05）。肠炎反复发作组术前营养不良、小肠结肠炎、上呼吸道或肺部感染发生率与肠炎组相比差异均有统计学意义（P<0.05），而肠炎组与无肠炎组差异均无统计学意义（P>0.05）。多因素Logistic回归分析显示，术前营养不良、术前小肠结肠炎为小肠结肠炎反复发作的危险因素（OR=9.000,95%CI=1.355~59.783；OR=8.667,95%CI=1.526~49.220）。结论 术前营养不良、术前小肠结肠炎可能是先天性巨结肠小肠结肠炎反复发作的危险因素。

关键词: 先天性巨结肠, 小肠结肠炎, 复发, 危险因素

Abstract:

Objective To investigate non-surgical risk factors for recurrent Hirschsprung-associated enterocolitis (HAEC). Methods A retrospective analysis was conducted on clinical data of 67 cases with Hirschsprungs disease (HD) treated by the radical operation between January 2007 and January 2014 at Shanghai Childrens Medical Center affiliated to Shanghai Jiao Tong University School of Medicine. Patients suffered 3 or more episodes of enterocolitis were assigned to the recurrent HAEC group (HAEC-R group). Patients with 1 or 2 episodes were assigned to the HAEC group. Patients without enterocolitis were assigned to the control group. The non-surgical risk factors for recurrent HAEC were analyzed. Results Gender and age at radical surgery had no statistical differences among three groups (P>0.05). Clinical types of HD and the incidence of hypoalbuminemia had no statistical differences between the HAEC-R group and the HAEC group (P>0.05), but had significant statistical differences between the HAEC-R group and the control group (P<0.05). The differences in the incidences of preoperative malnutrition, enterocolitis, upper respiratory tract infection, and pneumonia between the HAEC-R group and the HAEC group were statistically significant (P<0.05) and the differences between the HAEC group and the control group were not statistically significant (P>0.05). The multivariate logistic regression analysis showed that preoperative malnutrition and enterocolitis were independent risk factors for recurrent HAEC (OR=9.000, 95%CI=1.355-59.783; OR=8.667, 95%CI=1.526-49.220). Conclusion The preoperative malnutrition and enterocolitis may be risk factors for recurrent HAEC.

Key words: Hirschsprung’s disease, enterocolitis, recurrence, risk factor