儿童超短肠综合征治疗分析.

From January 2015 to February 2021, retrospective review was conducted for 24 USBS infants. Clinical characteristics, treatments and outcomes were recorded. There were 17 boys and 7 girls with a gestational age of (26-39+5) week and a range of birth weight (720-3 600) gram. The infants were premature (n=20) and full-term (n=4). Results Among them, 7 infants of temporary USBS were discharged upon completing short-term nutritional therapy after closing stoma; 7/17 infants of non-temporary USBS were weaned off parenteral nutrition to achieve intestinal adaptation; 5/17 relinquished further treatments during operation; 5/17 required continued parenteral nutrition. Among 19 survivors, there were intravenous nutrition-related cholestasis (n=9), catheter infection (n=9), acquired zinc deficiency dermatitis (n=3), vitamin D deficiency (n=6) and metabolic bone disease (n=2). All symptoms improved after symptomatic measures. Conclusions It is rather troublesome to manage USBS children and there are numerous complications. After proper treatments, some infants may finally achieve intestinal adaptation without parenteral nutrition. [ABSTRACT FROM AUTHOR]

目的 总结超短肠综合征(ultra-short bowel syndrome, USBS)的治疗经验, 并分析其预后。方法 回顾性分析2015年1月至2021年2月浙江大学医学院附属儿童医院新生儿外科收治的24例超短肠综合征患儿临床资料, 总结其临床特点、治疗经过及预后情况。结果 24例患儿中, 男17例, 女7例; 早产儿20例, 足月儿4例; 胎龄26~39+5周; 出生体重720~3 600 g。7例暂时性USBS患儿于造口关闭后行短期营养治疗痊愈; 17例非暂时性USBS患儿中, 7例脱离肠外营养达到肠适应, 5例放弃治疗(出院后死亡), 5例需继续肠外营养支持治疗。19例存活USBS患儿治疗过程中, 发生静脉营养相关性胆汁淤积9例, 导管感染9例, 获得性锌缺乏皮炎3例, 维生素D缺乏6例, 代谢性骨病2例; 均经对症治疗后好转。结论 超短肠综合征治疗困难, 并发症多, 经合理治疗, 部分患儿可脱离肠外营养达到肠适应。 [ABSTRACT FROM AUTHOR]