摘要
目的分析经脐单部位腹腔镜手术(laparoendoscopic single site surgery,LESS)联合右美托咪定治疗先天性肠闭锁(congenital intestinal atresia,CIA)对肠功能、血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平、生长激素(growth hormone,GH)、胰岛素样生长因子结合蛋白(insulin-like growth factor binding protein,IGFBP)-3及肠道屏障功能标志物的影响。方法选择我院2022年6月至2024年6月收治的CIA新生儿206例为研究对象,随机分为观察组和对照组,每组103例。对照组接受LESS,观察组在对照组治疗基础上加用右美托咪定。对比两组术后留置胃管时间、首次排气时间、并发症发生率及肠道功能恢复等指标。结果观察组肠梗阻、吻合口痿、腹泻等并发症发生率低于对照组(P<0.05),留置胃管时间和首次排气时间均短于对照组(P<0.05)。观察组总蛋白、白蛋白和血红蛋白水平明显优于对照组(P<0.05)。观察组再次喂养时间、全程喂养时间均短于对照组(P<0.05)。观察组血清NSE改善情况优于对照组(P<0.05),GH、IGFBP-3水平高于对照组(P<0.05)。观察组肠道屏障功能标志物水平高于对照组,肠道通透性较对照组显著改善(P<0.05)。结论LESS联合右美托咪定可降低CIA患儿术后并发症发生率,缩短术后恢复时间,改善肠内营养,调节血清NSE水平,促进GH、IGFBP-3水平提升,并改善肠道屏障功能,有一定临床推广价值。
Objective To analyze the effects of transumbilical laparoendoscopic single site surgery(LESS)combined with dexmedetomidine in the treatment of congenital intestinal atresia(CIA)on intestinal function,serum neuron-specific enolase(NSE)level,growth hormone(GH),insulin-like growth factor binding protein(IGFBP)-3 and markers of intestinal barrier function.Methods A total of 206 newborns with CIA admitted to our hospital from June 2022 to June 2024 were selected as the study objects and randomly divided into observation group and control group,with 103 cases in each group.The control group received LESS,and the observation group was treated with dexmedetomidine on the basis of control group.The time of indwelling gastric tube,first exhaust time,the incidence of complications and intestinal function recovery were compared between the two groups after surgery.Results The incidence of intestinal obstruction,anastomotic impotence,diarrhea and other complications in the observation group was lower than that in the control group(P<0.05),and the time of indwelling gastric tube and first exhaust time were shorter than those in the control group(P<0.05).The levels of total protein,albumin and hemoglobin in the observation group were significantly better than those in the control group(P<0.05).The refeeding time and the whole feeding time of the observation group were shorter than those of the control group(P<0.05).The improvement of serum NSE in the observation group was better than that in the control group(P<0.05),and the levels of GH and IGFBP-3 were higher than those in the control group(P<0.05).The levels of intestinal barrier function markers in the observation group were higher than those in the control group,and the intestinal permeability was significantly improved compared with the control group(P<0.05).Conclusion LESS combined with dexmedetomidine can reduce the incidence of complications after CIA,shorten the postoperative recovery time,improve enteral nutrition,regulate serum NSE level,promote the level of GH and IGFBP-3,and improve intestinal barrier function,which has certain clinical value.
作者
乔春玲
张钰琪
李彦彦
张宁
QIAO Chunling;ZHANG Yuqi;LI Yanyan;ZHANG Ning(Department of Neonatology,Xuzhou Children's Hospital,Xuzhou 211033,Jiangsu Province,China)
出处
《世界临床药物》
2025年第3期260-265,276,共7页
World Clinical Drug
基金
徐州市儿童医院2022年度科研立项项目(22040411)。
关键词
经脐单部位腹腔镜手术
右美托咪定
先天性肠闭锁
胰岛素样生长因子结合蛋白
肠内营养
laparoendoscopic single site surgery
dexmedetomidine
congenital intestinal atresia
insulin-like growth factor binding protein
enteral nutrition
