Comparison Research Of Clinical Effect Betwwen Intestinal Anastomosis And Ileostomy In The Treatment Of Isolated Intestinal Perforation

Neonatal intestinal perforation is not a rare but a fatal disease in neonates,especially low birth weight premature infants.This disease is often caused by many factors,such as neonatal necrotizing enterocolitis,congenital anal atresia,congenital megacolon etc.Isolated intestinal perforation is a rare cause of the neonatal intestinal perforation.The simple perforation of the intestine is a kind of intestinal perforation with no primary lesion and no history of trauma.The pathogenesis is still not clear.Isolated intestinal perforation is seen as early manifestations of neonatal necrotizing enterocolitis or a special type and it is seen as a independent occurrence of disease in the 1980 s.Isolated intestinal perforation has rapid development,lack of early clinical manifestations and imaging diagnosis is not obvious,so it is a serious threat to children with the clinical problems of life.It is reported that the simple perforation of the newborn is very low in the birth weight infants and the perforation rate is about3% ~ 6%,in addition,about 83% occurs in the ileocecal region and the spleen flexure of the colon.Foreign literature reports that bowel dysfunction,septicemia,blood hypoperfusion,dexamethasone,indomethacin,application of congenital intestinal developmental defects and other factors are high risk factors of neonatal herpes intestinal perforation.Although the etiology and mechanism of neonatal simpleintestinal perforation have many kinds of views,it is still unclear.Surgery is the only way to cure the simple perforation of the intestine.Many articles have reported that intestinal anastomosis and colostomy can be used as the operative method.This paper selects 23 cases in the Department of general surgery,the Third Affiliated Hospital of Zhengzhou University underwent colostomy and intestinal anastomosis simple intestinal perforation in neonates,to compare the clinical efficacy of two surgical methods,selection of surgical methods better.ObjectiveTreatment of isolated intestinal perforation poses a serious challenge to neonatal surgery.Intestinal anastomosis and colostomy have long been considered as the classic surgical treatment of the disease,but few reports have been made on the two surgical procedures.Our purpose is to analyze and compare two kinds of intestinal anastomosis and intestinal fistula surgery and choose a more suitable way for isolated intestinal perforation in the treatment of children.Materials and methodAccording to the inclusion criteria,23 cases of isolated intestinal perforation in the Department of general surgery of the First Affiliated Hospital of Zhengzhou University from 2014 to 2016 were included in the study.The patients were divided into the experimental group and the control group.The two groups were compared between peritonitis,operation time,intraoperative blood loss,postoperative hospital stay,recovery time of gastrointestinal function.The data was analyzed by SPSS 21.0software,and the data were tested by X2 test.The data were analyzed by t test.The difference was statistically significant with P<0.05.Results1.There was no significant difference between the experimental group and the control group in the clinical data such as gestational age,birth weight,age atadmission and so on in the two groups(P>0.05).2.Compared with the intestinal anastomosis group,the amount of bleeding in the operation group was significantly lower(P=0.009),and there was no significant difference between the two groups(P=0.682,P=0.643).3.In the near future curative effect,the intestinal function recovery time and postoperative hospital stay were significantly shorter(P=0.000,P=0.001)in the intestinal fistula group,but there was no significant difference between the two groups(P=0.400).4.In the long term curative effect,postoperative intestinal obstruction,postoperative death,and the two operation,the incidence of neonatal enterocolitis was significantly lower than that of intestinal anastomosis group(P=0.029,P=0.019,P=0.009,P=0.048).Conclusions1.Colostomy and intestinal anastomosis,can effectively reduce the intraoperative bleeding volume,shorten the time of postoperative recovery of gastrointestinal function and postoperative hospitalization time,reduce postoperative ileus,postoperative mortality,worthy of promotion in clinical use.2.Colostomy can shorten the length of hospital day and reduce the postoperative mortality,thereby it is worthy of clinical promotion.