Relevant Factors Of Post-operation Enterocolitis In Hischsprung’s Disease

Objective To screen out the high risk factors by analyzing the related factors of Hirschsprung-associated enterocolitis,and to provide theoretical basis for clinical prevention and treatment of enterocolitis after pull-through operation.Methods In this paper,194 children with Hirschsprung’s disease diagnosed pathologically after pull-through operation in the First Affiliated Hospital of Guang Xi Medical University from August 2012 to August 2018 were followed up,and the case data were retrospectively studied.The patients were divided into Enterocolitis group and Non-enterocolitis group according to whether enterocolitis happened after operation.Single-factor and multi-factors binary logistic regression analysis were carried out in turn to determine the risk factors of enterocolitis after congenital pull-through operation combined with clinical practice.Results A total of 163 children undergoing radical mastectomy were enrolled in the study,including 137 males and 26 females,with a male to female ratio of 5.27:1.There were 73 cases of enterocolitis after operation,the incidence rate was 44.79%,64 males and 9 females,the ratio of male to femalewas 7.11:1.There were 78 children with ≤ 1 year old,37 cases with postoperative enteritis,the incidence rate was 47.43%,42 cases were 1-3 years old,26 cases were postoperative enteritis,the incidence rate was 61.90%,43 cases were ≥3 years old,postoperative enteritis 10 cases,the incidence rate was23.25%.Single-factor analysis of the factors related to enterocolitis showed that there were no statistical differences in sex ratio,operation times,surgical approach and treatment of rectal muscle sheath between the two groups(P >0.05).The operation age,preoperative enteritis,postoperative anal dilatation,postoperative intestinal obstruction,the type of megacolon and the scope of colon resection were compared between the two groups,P <0.05,the difference was statistically significant.Independent-samples T-test results showed that there was no statistical difference in Body mass index(BMI),White blood cells,Red blood cells,Hemoglobin,Albumin and Prealbumin between the two groups before operation(P > 0.05).The preoperative globulin level in enterocolitis group was lower than that in non-enterocolitis group,(P < 0.05),and the difference was statistically significant.The statistically significant factors in the above single-factor test were included in the multi-factors binary logistic regression analysis,which showed that preoperative enteritis P=0.008,OR=5.425,postoperative intestinal obstruction P=0.004,OR=7.774 were the main risk factors for postoperative enterocolitisConclusion Post-operation enterocolitis after Hirschsprung’s disease is the result of multiple factors.Preoperative enteritis and post-operative intestinal obstruction are the high risk factors for post-operative enterocolitis.Clinicians and family members of children with Hirschsprung’s disease should strengthen the understanding of preoperative and post-operative risk factors,and takecorresponding preventive and therapeutic measures according to these risk factors to reduce the incidence of enterocolitis.