Study Of Risk Factors Associated With Adhesive Intestinal Obstruction In Children After Abdominal Surgery

ObjectiveTo retrospectively analyze the risk factors of intestinal adhesion and intestinal obstruction in children after undergoing abdominal surgery.In order to find out effective and preventive measures,with those we can improve the reference for practical clinical works.Methods1.Collecting the clinical data of all children,aged 0 to 15,who underwent abdominal surgery in the General Hospital of Ningxia Medical University from January 1,2016 to January 1,2018.2.According to whether there is adhesion intestinal obstruction after operation,divided it into adhesion obstruction group(54 cases)and non-adhesion obstruction group(723cases).Compare the sex,age,nation,season of onset,primary infectious disease,duration of medical history,timing of surgery,preoperative WBC,preoperative NEUT%,preoperative HGB,preoperative ALB,and preoperative electrolyte disorders(Na~+,K~+),and surgery duration,type of incision,ASA classification,surgical method,whether to use incision protectors,whether to use anti-adhesive materials,whether to flush the abdominal cavity,whether to place drainage,whether to perform bowel resection and anastomosis,whether to give blood,whether to postoperative gastrointestinal decompression,Use of antibiotics,whether to use special grade antibiotics,duration of postoperative parenteral nutrition,incision healing,length of hospital stay,etc.3.Aggregate and tabulate all data,use SPSS22.0 statistical software for data analysis,measurement data using t test,count data using chi-square test,statistically significant factors using multi-factor Logistic regression analysis,and Calculate the relative risk OR of each factor.Test standard?=0.05,P<0.05,indicating that the difference is statistically significant.Finally,the independent risk factors of adhesion intestinal obstruction in children were obtained.Result1.A total of 777 samples were counted,of which 54 cases of AIO occurred after abdominal surgery,the incidence rate was 6.95%.2.Single factor analysis shows:gender,ethnicity,duration of medical history,timing of surgery,whether electrolyte disorders occurred before surgery,whether anti-adhesive materials were used,whether the abdominal cavity was flushed,whether abdominal drainage was placed,whether bowel resection and anastomosis were performed,whether postoperative gastrointestinal decompression,the use of antibiotics,and the use of special grade antibiotics were not statistically significant(P>0.05).They were irrelevant factors for postoperative abdominal intestinal obstruction.3.Single factor analysis shows:age,season of onset,primary infectious disease,preoperativeWBC,preoperativeNEUT%,preoperativeHGB,preoperative ALB,duration of operation,type of incision,ASA staging,surgical method,whether to use incision protection.There were statistically significant differences in device,perioperative blood transfusion,duration of parenteral nutrition use,incision healing,and length of hospital stay(P<0.05)as risk factors for children with adhesive intestinal obstruction after abdominal cavity surgery.4.Taking the occurrence of postoperative adhesion intestinal obstruction as the dependent variable,multivariate logistic regression analysis was used to obtain 4 independent factors affecting children's postoperative adhesion intestinal obstruction.The order of influence was:primary infectious disease(OR=2.024),low protein(OR=1.490),use of incision protector(OR=0.484),length of hospital stay(OR=0.071).Conclusion1.The use of an incision protector and a reasonable and appropriate length of hospital stay are independent protective factors for children with postoperative adhesive intestinal obstruction.2.Preoperative low protein and primary infectious diseases are independent risk factors for children with postoperative adhesive intestinal obstruction.