A New Direction For The Treatment Of Necrotizing Enterocolitis In Surgery

Objective:To investigate the treatment effect on the process of NEC childrenwith the disease and prognosis of early operation.To explore a newmethod--intestinal gastric drainage tube applicated in theclinical of NEC in the surgical treatment.Methods:A retrospective analysis of our Hospital in recent8years,neonatal and pediatric surgery in the diagnosis and treatment ofneonatal necrotizing enterocolitis cases.1.According to themodified Baer stage, stage Ⅱ44cases, divided into two groups:operation group and non operation immediately immediatelyimmediately operation treatment group, operation group and nonoperation group, immediately to the conservative treatment, ifthere is disease is treated by operation, the survival werefollowed up to6months, the incidence of two the survival rateof mice and incomplete intestinal obstruction.2.The choice ofoperation are found in the intestinal lesions could notimmediately confirm the extensive resection of28cases of NECpatients, according to a phase of the operation mode is different, divided into two groups: traditional operation group andintestinal catheter drainage group. The traditional operationmethod is a stage for colostomy exteriorization of intestine, or24hours after intestinal resection and colostomy, the survivalof children2-3months after the two period of intestinal fistulaclosure. Intestinal catheter drainage operation method is a stagefor intestinal catheter drainage, postoperative7-10days toexplore life underwent intestinal anastomosis of intestine andintestinal fistula, fistula in children2-3months after the closeof intestinal fistula. Survival patients were followed for up to6months,6months after operation were collected weight,defecation frequency, incomplete intestinal obstruction occurred,the cure rate and prognosis were compared between the two kindsof operation mode.Results:1. The development of NEC in children from ⅡB to Ⅲduring theperiod of conservative treatment, the incidence rate was50%.Operation group and non operation immediately immediately groupsurvival rates were87.5%and57.1%， that difference wassignificant (P<0.05). The complication rate of incompleteintestinal obstruction were immediately operation group14.3%,and non immediate operation group was56.3%, that was significantdifference between them (P<0.05) ⅡB operation immediately is with a higher survival rate, less complications.2. For the existence of extensive intestinal lesions in children,intestinal catheter drainage group and traditional operationgroup, the cure rates were81.3%and41.7%，and the averageoperation time was42±13minutes and66±16minutes.Sixmonths later， the operation to cure children with weight averagevalues were6.96±1.25Kg and5.64±1.30kg，and defecation theabnormal rates was23.1%and80%,and incomplete intestinalobstruction occurred was38.5%and80%, which differentstatistical indicators were significantly different (P<0.05).Conclusion：1. Operation intervention of children with NEC can improve therate of early NEC children’s survival，and reduce mortality，andreduce the occurrence of complications.2. A period of intestinal catheter drainage in the treatment ofintestinal lesions exist widely in children，which is a new modeof operation，with shorter operation time，higher cure rate andpostoperative intestinal nutrition status can recover faster，betterfewer complications，which is worthy of clinical promotion.