Predictors of a successful outcome for infants with short bowel syndrome: a 30-year single-institution experience
Predictors of a successful outcome for infants with short bowel syndrome: a 30-year single-institution experience
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DOI：
10.1007/s00595-017-1534-6
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发表时间：
2017-11-01
期刊：
影响因子：
2.5
通讯作者：
Ieiri, Satoshi
中科院分区：
文献类型：
--
作者：
Kaji, Tatsuru;Nakame, Kazuhiko;Ieiri, Satoshi
短肠综合征(SBS)具有较高的发病率和死亡率。我们进行了这项研究，以建立存活和撤除肠外营养(PN)的预测因素。我们回顾了30年来在我们机构接受治疗的16名SBS婴儿的医疗记录。SBS定义为残留小肠长度(RSBL)为75厘米。评估了回盲瓣丢失(ICV)、胆汁淤积(D-Bil&Gt；2.0 mg/dl)、肠造口术和RSBL。预测因素采用Kaplan-Meier分析，平均RSBL为34.9+/-22.9 cm。死亡6例(37.5%)，撤机9例(56.3%)。在胆汁淤积(p<；0.03)、肠造口术(p<；0.01)、绝对RSBL为<；30 cm(p<；0.04)和预期RSBL百分比为<；10%(p<；0.04)作为生存预测因素方面观察到显著差异。在胆汁淤积(P<；0.01)、ICV丢失(P<；0.04)、绝对RSBL为<；20 cm(P<；0.01)和预期RSBL为<；10%(P<；0.03)方面也观察到了显著差异，这些预测因素可以帮助我们为患有SBS的儿童患者选择最佳治疗方案。
Short-bowel syndrome (SBS) is associated with high morbidity and mortality. We conducted this study to establish the predictors of survival and weaning off parenteral nutrition (PN).We reviewed the medical records of 16 SBS infants treated at our institution within a 30-year period. SBS was defined as a residual small-bowel length (RSBL) of < 75 cm. Loss of the ileocecal valve (ICV), cholestasis (D-Bil > 2.0 mg/dl), enterostomy, and RSBL were all evaluated. Kaplan-Meier analysis was used to analyze the predictors.The mean RSBL was 34.9 +/- 22.9 cm. Six patients died (37.5%) and nine patients were weaned off PN (56.3%). Significant differences were observed in cholestasis (p < 0.03), enterostomy (p < 0.01), an absolute RSBL of < 30 cm (p < 0.04), and a percentage of expected RSBL of < 10% (p < 0.04) as survival predictors. Significant differences were also observed for cholestasis (p < 0.01), loss of the ICV (p < 0.04), an absolute RSBL of < 20 cm (p < 0.01), and a percentage of expected RSBL of < 10% (p < 0.03) as predictors of weaning off PN.These predictors may help us select the optimal treatments for pediatric patients with SBS.