Infantile hypertrophic pyloric stenosis - Our experience and challenges in a developing country.
Infantile hypertrophic pyloric stenosis - Our experience and challenges in a developing country.
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DOI：
10.4103/ajps.ajps_51_16
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Obianyo, Nene Elsie
中科院分区：
文献类型：
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作者：
Ezomike, Uchechukwu Obiora;Ekenze, Sebastian Okwuchukwu;Obianyo, Nene Elsie
背景技术背景：本研究旨在评估管理婴儿肥厚性幽门狭窄（IHPS）患者的经验和挑战。患者和方法：从2007年1月至2015年12月，使用SPSS 15版回顾性采集并分析IHPS患者的数据。Pearson相关性用于评估线性关系，Student t检验用于比较平均值。P < 0.05为有统计学意义。结果：26例患者的平均诊断年龄为49.16 ± 21.4天。平均出生体重为3.7 kg，就诊时平均体重为3.3 kg。29%的头胎受影响; 91%为足月分娩; 9%为过期分娩;无早产; 36%为纯母乳喂养。平均症状持续时间为25.6 ± 18.9天。低钠血症占36%，低钾血症占37.5%，水肿占35%，低氯血症占62%。幽门肿瘤平均长度为22.85 ± 6.56 mm，幽门壁平均厚度为5.51 ± 1.36 mm，症状持续时间与血清钾水平显著相关（R =-0.6326，P = 0.002）。低钾血症患者的平均症状持续时间为39.88 ± 23.41天，无低钾血症患者为17.15 ± 9.78天（P = 0.006）。平均住院时间为9.45 ± 3.27天。4例患者发生4例并发症，3例患者死亡（11.5%）。术前死亡患者的平均发病年龄为84 ± 39天，其他患者的平均发病年龄为46 ± 17.98天（P = 0.015）。有一个显着的正相关关系的症状持续时间和血清钾水平和平均持续时间的症状是显着较长的低钾血症。术前死亡率与症状持续时间较长显著相关。
BACKGROUND: This study aims to evaluate the experience and challenges in managing patients with infantile hypertrophic pyloric stenosis (IHPS).PATIENTS AND METHODS: From January 2007 to December 2015, data from patients with IHPS were retrospectively acquired and analyzed using SPSS version 15. Pearson correlation used to assess linear relationships and Student t-test to compare means. P < 0.05 was taken as statistically significant. Results were expressed as percentages, means ± standard deviation and illustrated in tables and graphs.RESULTS: Twenty-six cases were managed with the mean age at diagnosis of 49.16 ± 21.4 days. Mean birth weight was 3.7 kg and mean weight at presentation was 3.3 kg. Firstborn was affected in 29%; 91% were term deliveries; 9% were post-term; none was preterm; and 36% were exclusively breastfed. Mean duration of symptoms was 25.6 ± 18.9 days. Hyponatraemia was seen in 36%, hypokalaemia 37.5%, alkalosis 35% and hypochloraemia 62%. Mean pyloric tumour length was 22.85 ± 6.56 mm and pyloric wall thickness 5.51 ± 1.36 mm. There was a significant correlation between duration of symptoms and serum potassium level (R = -0.6326, P = 0.002). Mean symptom duration in patients with hypokalaemia was 39.88 ± 23.41 days and without hypokalaemia 17.15 ± 9.78 days (P = 0.006). Mean hospital stay was 9.45 ± 3.27 days. Four patients developed four complications and three patients died (11.5%). Mean age at presentation for pre-operative mortalities was 84 ± 39 days and 46 ± 17.98 days for others (P = 0.015).CONCLUSIONS: IHPS presents late in our environment and occurs mainly in term males. There is a significant positive relationship between duration of symptoms and serum potassium level and the mean duration of symptoms was significantly longer in those with hypokalaemia. Pre-operative mortality was significantly associated with longer duration of symptoms.