Clinical application of enhanced recovery after surgery combined with intestinal fluid reflux in enterostomy in newborn
10.3760/cma.j.issn.2096-2932.2024.03.004
- VernacularTitle:加速康复理念联合早期肠液回输在新生儿小肠造瘘术后的临床应用
- Author:
Wenyue LIU
1
;
Xiaoxia WU
;
Hui ZHANG
;
Xue SUN
;
Baohong ZHAO
;
Yuanyuan JIN
;
Hongxia REN
Author Information
1. 山西省儿童医院新生儿外科，太原 030013
- Keywords:
Enhanced recovery after surgery;
Intestinal fluid reflux;
Enterostomy;
Newborn
- From:Chinese Journal of Neonatology
2024;39(3):145-149
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical value of enhanced recovery after surgery(ERAS) strategy combined with early intestinal fluid reinfusion among neonates receiving jejunostomy due to intestinal obstruction.Methods:From December 2018 to December 2022, neonates with intestinal obstruction receiving jejunostomy in the Department of Neonatal Surgery of our hospital were prospectively enrolled. They were randomly assigned into ERAS group and traditional treatment (TT) group after surgery. The ERAS group was treated with ERAS strategy plus early intestinal fluid reinfusion. The TT group was treated with conventional gastrointestinal decompression, analgesia as needed and enteric fluid reinfusion according to the amount of defecation. The postoperative parenteral nutrition (PN) duration (T pn), central venous catheter (CVC) duration (T cvc), daily weight gain, duration of postoperative hospital stay (T hos), complications and readmission rate within 30 days were compared between the two groups. Results:A total of 22 cases were included in the ERAS group and 20 cases were in the TT group. T pn [(22.6±9.4) d vs. (30.7±11.3) d], T cvc [(5.9±0.8) d vs. (9.9±2.1) d] and T hos [(26.8±9.8) d vs. (33.8±11.5) d] in the ERAS group were significantly shorter than the TT group ( P<0.05). No significant difference existed in daily weight gain between the two groups ( P>0.05). The incidence of postoperative gastrointestinal mucosal bleeding in the ERAS group was significantly lower than the TT group (13.6% vs. 45.0%)( P<0.05). No significant differences existed in the following items between the two groups: feeding intolerance, PN-associated cholestasis, CVC-related bloodstream infection, intestinal fluid reinfusion-related complications, premature closure of fistula and readmission rate within 30 days (all P>0.05). Conclusions:The application of ERAS strategy plus early intestinal fluid reinfusion in neonates with enterostomy is safe and feasible, which can reduce the postoperative durations of PN, CVC and hospital stay and accelerate the recovery.
