摘要
目的探讨婴儿先天性巨结肠症术前灌肠生理盐水的合适用量。方法将63例常见型先天性巨结肠症患儿随机分为三组各21例,观察A组每次灌肠量为150ml/kg体质量,观察B组每次灌肠量为200ml/kg体质量,对照组每次灌肠量为100ml/kg体质量。观察三组患儿第1次灌肠前和最后1次灌肠后血电解质指标,术中由同1名主刀医生采用盲法按标准对灌肠效果进行评价并记录手术时间,术后观察三组患儿肛周红肿情况及住院时间。结果观察A、B组与对照组比较,灌肠效果好、手术时间短、术后肛周红肿发生率低、住院时间短(P<0.05,P<0.0125);观察A组灌肠舒适度显著优于观察B组(P<0.05),其余各项指标比较,差异无统计学意义(均P>0.05);三组灌肠前后血电解质指标无显著变化(均P>0.05)。结论婴儿先天性巨结肠症术前每次灌肠生理盐水用量宜以150ml/kg体质量计算,可提高灌肠效果,减少术后并发症,缩短手术和住院时间,且不会导致电解质紊乱,并提高灌肠舒适度。
Objective To explore the suitable dosage of normal saline for enema per time in infants with congenital giant colon before operation. Methods A total of 63 infants with congenital giant colon were enrolled and randomly divided into three groups equally. The amount of normal saline for enema was 150 ml/kg, 200 ml/kg and 100 ml/kg per time in experimental group A, experimental group B and control group respectively. The values of electrolytes were tested before enema and after the last enema, the enema effect was assessed by a doctor during operation and the operation time was recorded, and the incidence of perianal irritation and length of hospital stay were recorded. Results Compared to the control group, the enema effect, operation time, incidence of perianal irritation and the length of hospital stay in experimental group A, group B showed significant differences（P〈0.05, P〈 0. 0125）. The degree of comfort in experimental group A was significantly higher than that of group B（P〈0.05）, the other indexes showed no significant differences between the two experimental groups（P〈0.05 for all）. Conclusion The optimal dosage of normal saline for enema in infants with congenital giant colon before operation requires 150ml/kg per time; it can improve enema effect, decrease incidence of postoperative complications, shorten operation time and length of hospital stay, keep a balance of electrolytes and promote infants＇ comfort.
