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Chinese Journal of Colorectal Diseases(Electronic Edition) ›› 2018, Vol. 07 ›› Issue (05): 468-471. doi: 10.3877/cma.j.issn.2095-3224.2018.05.012

Special Issue:

• Original Article • Previous Articles     Next Articles

Influence of early and delayed surgical treatment of neonatal necrotizing enterocolitis on prognosis and intestinal obstruction risk

Guihua Zhang1,(), Yanping Jia1, Feng Chen1, Taiping Zhuang2   

  1. 1. Department of Neonatology, Maternal and Child Care Service Centre of Haikou City, Haikou 570102, China
    2. Department of Neonatology, Maternal and Child Care Service Centre of Hainan Province, Haikou 570000, China
  • Received:2018-04-08 Online:2018-10-25 Published:2018-10-25
  • Contact: Guihua Zhang
  • About author:
    Corresponding author: Zhang Guihua, Email:

Abstract:

Objective

To observe the influence of early and delayed surgical treatment of neonatal necrotizing enterocolitis on the prognosis and the intestinal obstruction risk.

Methods

A total of 60 cases of neonatal necrotizing enterocolitis in Maternal and Child Care Service Centre of Haikou City from January 2015 to February 2017 were randomly divided into observation group and control group, thirty cases in each group. Both groups were received enteral external catheter drainage. The group A was taken early surgery, and group B was taken delayed surgery. The patients were followed up for 6 months. The mortality, total complication rate were compared between the two groups. And the incidences of defecation, incomplete intestinal obstruction during follow-up, body weight at the end of follow-up were compared between the two groups.

Results

The total mortality in group A was 10.00%, which was lower than 26.67% in group B, while the difference was not statistically significant (χ2=2.783, P=0.095). There was no complication in group A, and the total complication rate in group B was 26.67%. The difference was statistically significant (χ2=7.067, P=0.008). 6 months after surgery, the body weight of group A was (7.02±1.15) Kg, which was significantly higher than (5.75±1.02) Kg in group B (t=4.525, P=0.000). There was no significant difference in the incidence of defecation between the two groups (χ2=0.288, P=0.840). The incidence of incomplete intestinal obstruction in group A was 18.52% (5/27), which was significantly lower than 50.00% (9/18) in group B (χ2=5.860, P=0.015).

Conclusion

The treatment of neonatal necrotizing enterocolitis by enteral external catheter drainage can drain and reduce tension of intestine, reduce the intestinal absorption of toxins, avoid excessive removal of the intestine, and achieve a good prognosis. Early surgery can further reduce the complications, therefore it can improve survival rate, reduce the risk of postoperative intestinal obstruction, which is worth promoting.

Key words: Prognosis, Intestinal obstruction, Necrotizing enterocolitis of newborn, Enteral external catheter drainage, Early surgery, Delayed surgery

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