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【目的】探讨0～3月先天性消化道畸形住院患儿的临床特征和预后影响因素,为制定其有效救治体系提供科学依据。【方法】选取湖南省儿童医院新生儿外科1年内收治的466例先天性消化道畸形患儿。采用单因素Lo-gistic回归和多因素Logistic回归统计分析其基本特征和预后影响因素。【结果】466例患儿中,男332例,占71.24%;女134例,占28.76%。农村367例,占78.76%;城市99例,占21.24%。农村较城市易发生水电解质紊乱、肺炎、腹膜炎、消化道穿孔和营养不良等并发症。治愈385例,占82.62%;好转13例,占2.79%;放弃32例,占6.87%;死亡36例,占7.73%。其中农村死亡32例,城市死亡4例,农村患儿的病死率高于城市。通过单因素Logistic回归分析,影响患儿住院转归的因素主要是:感染性休克、呼吸衰竭、败血症、DIC和硬肿症等。经多因素Logistic回归分析,影响患儿住院转归的因素主要是:呼吸衰竭、消化道穿孔、败血症和发病日龄。【结论】先天性消化道畸形的预后与感染性休克、呼吸衰竭、消化道穿孔、败血症、DIC和硬肿症等密切相关。先天性消化道畸形防治工作的重点在农村。开展产前诊断,早期诊断,普及相关知识,早期手术治疗和提高医院的救治水平可提高该病的治愈率。
【Objective】 To investigate the clinical characteristics and prognostic factors of children with congenital gastrointestinal malformations from January to March in order to provide a scientific basis for making effective treatment system. 【Methods】 A total of 466 children with congenital gastrointestinal malformations admitted to Department of Neonatology, Children’s Hospital of Hunan Province within one year were enrolled. Single factor Lo-gistic regression and multivariate Logistic regression analysis of the basic characteristics and prognostic factors. 【Results】 Of the 466 children, 332 were male, accounting for 71.24%; 134 were female, accounting for 28.76%. 367 rural areas, accounting for 78.76%; 99 cities, accounting for 21.24%. Rural cities prone to water and electrolyte disorders, pneumonia, peritonitis, gastrointestinal perforation and malnutrition and other complications. 385 cases were cured, accounting for 82.62%; 13 cases improved, accounting for 2.79%; 32 cases were abandoned, accounting for 6.87%; 36 cases died, accounting for 7.73%. Among them, 32 cases were rural deaths and 4 cases were urban deaths. The case fatality rate in rural areas was higher than that in cities. By univariate Logistic regression analysis, the main factors affecting the hospitalization of children were: septic shock, respiratory failure, sepsis, DIC and scleredema and so on. The multivariate Logistic regression analysis showed that the main factors influencing the hospitalization of children were respiratory failure, gastrointestinal perforation, sepsis and the age of onset. 【Conclusion】 The prognosis of congenital digestive tract deformity is closely related to septic shock, respiratory failure, gastrointestinal perforation, sepsis, DIC and scleredema. Congenital gastrointestinal deformity prevention and control work in rural areas. To carry out prenatal diagnosis, early diagnosis, popularization of relevant knowledge, early surgical treatment and improve the level of hospital treatment can improve the cure rate of the disease.