临床小儿外科杂志2025，Vol.24Issue(4)：351-355,5.DOI:10.3760/cma.j.cn101785-202409065-009
胎粪性腹膜炎产前产后一体化诊治的结局探讨
Outcomes of integrated prenatal diagnosis and postpartum treatment of meconium peritonitis
摘要
Abstract
Objective To explore the clinical outcomes and significance of integrated prenatal diagnosis and postpartum treatment of meconium peritonitis(MP).Methods A retrospective analysis was conducted for the relevant clinical data of 81 neonates born with MP operated at Department of Neonatal Surgery,Children's Hospital of Shanxi Province,from October 2011 to July 2024.According to whether the neonates received inte-grated prenatal diagnosis and postpartum treatment,they were assigned into two groups of integrated prenatal di-agnosis and postpartum treatment(n=27)and non-integrated prenatal diagnosis and postpartum treatment(n=54).The inter-group differences in general perioperative profiles,length of hospitalization stay,pathological type,surgical approach and presence of postoperative complications were compared.Based upon clinical out-comes,they were also divided into two groups of abandonment/death(n=21)and survival(n=60).Integrat-ed prenatal diagnosis and postpartum treatment was employed as an important influencing factor for comparing the inter-group differences in general profiles,pathological types and surgical approaches.Furthermore the prog-nostic impact of integrated prenatal diagnosis and postpartum treatment was examined through multifactorial Lo-gistic regression analysis.Results Preoperative level of C-reactive protein(CRP)and case number of aban-donment/death were lower in integrated prenatal diagnosis and postpartum treatment group than those in non-in-tegrated prenatal diagnosis and postpartum treatment group[0.50(0.50,2.37)vs.9.91(2.07,25.84)g/L;2(7.04％)vs.19(35.2％)].There were statistically significant differences(P＜0.001,P=0.007).In clini-cal outcome groups,statistically significant differences existed in whether or not adopting integrated prenatal di-agnosis and postpartum treatment,pathological typing and postoperative complications of short bowel syndrome(SBS)(P=0.007,P=0.022,P=0.018).Integrated prenatal diagnosis and postpartum treatment(OR=5.951,95％CI:1.175～30.144,P=0.031)was a protective factor for the prognosis of MP patients.And the presence of SBS was a risk factor for the prognosis of MP children(OR=0.199,95％CI:0.053～0.744,P=0.016).Conclusions Integrated prenatal diagnosis and postpartum treatment may effectively control the pro-gression of MP,lower the rate of abandonment/mortality and have a positive significance for prognosis.关键词
胎粪性腹膜炎/围产期/疾病管理/病理状态,体征和症状/治疗结果/影响因素分析Key words
Meconium Peritonitis/Peripartum Period/Disease Management/Pathological Conditions,Signs and Symptoms/Treatment Outcome/Root Cause Analysis引用本文复制引用
吴莹,任红霞,吴晓霞,赵宝红,靳园园,刘文跃,赵亮..胎粪性腹膜炎产前产后一体化诊治的结局探讨[J].临床小儿外科杂志,2025,24(4):351-355,5.基金项目
山西省儿童医院院内课题(2023002) Project of Shanxi Provincial Children's Hospital(2023002) （2023002）
