Analysis of clinical characteristics and risk factors associated with incomplete intestinal obstruction in children with medulloblastoma
10.3760/cma.j.cn101070-20200410-00611
- VernacularTitle:髓母细胞瘤患儿合并不完全性肠梗阻的临床特征及相关危险因素分析
- Author:
Wenchao GAO
1
;
Yanling SUN
;
Shuxu DU
;
Siqi REN
;
Jin ZHANG
;
Miao LI
;
Xiaojun GONG
;
Wanshui WU
;
Liming SUN
Author Information
1. 首都医科大学附属北京世纪坛医院儿科 100038
- Keywords:
Incomplete intestinal obstruction;
Medulloblastoma;
Vincristine;
Child
- From:
Chinese Journal of Applied Clinical Pediatrics
2021;36(15):1148-1151
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of children with medulloblastoma (MB) complicated with incomplete intestinal obstruction, and to explore the possible pathogenesis of intestinal obstruction in children with MB.Methods:A total of 409 children with MB admitted to the Department of Pediatrics of Beijing Shijitan Hospital, Capital Medical University from October 2014 to January 2019 were recruited into this study, and the clinical data of children with incomplete intestinal obstruction were collected and analyzed retrospectively.A comparison was performed between these children and those without intestinal obstruction who were treated at the same time.The chi- squared test and Logistic regression analysis were adopted to explore the pathogenesis of intestinal obstruction.The overall survival (OS) rate was calculated with the Kaplan-Meier method. Results:There were 11 cases of 409 children with MB complicated with incomplete intestinal obstruction in total, with the morbidity of 2.7%, they were all over 3 years old, with the median age of 8.7 years, and a male-to-female ratio of 4.5∶1.The incomplete intestinal obstruction in all cases occurred during the first cycle of maintenance chemotherapy after radiotherapy.All these patients could be reco-vered after conservative treatment, and no incomplete intestinal obstruction occurred in the subsequent chemotherapy.The results of Logistic regression analysis showed that there was a correlation between age and the development of incomplete intestinal obstruction ( P<0.05). The 2-year OS rate of MB patients complicated with incomplete intestinal obstruction was (87.5±11.7)%, and that of patients without incomplete intestinal obstruction during the same period was (92.8±1.6)%, which showed that the difference between the two group was not statistically significant ( P>0.05). Conclusions:Incomplete intestinal obstruction would occur in all MB patients within 2 months after radiotherapy, and children more than 3 years old are more prone to suffer from this disease.Therefore, it can be supposed that gastrointestinal mucosa was damaged under the double attack of radiotherapy and Vincristine, which slowed down the intestinal peristalsis, thus inducing intestinal obstruction.
