극소저출생체중아에서 태변에 의한 장폐색에 관한 연구
Meconium Obstruction in Very Low Birth Weight Infants
홍기배, 성인창, 이건송, 장영표, 송희승,
소속 상세정보
홍기배 ( Hong Ki-Bae )
단국대학교 의과대학 소아청소년과학교실
성인창 ( Seong In-Chang )
단국대학교 의과대학 소아청소년과학교실
이건송 ( Lee Kun-Song )
단국대학교 의과대학 소아청소년과학교실
장영표 ( Chang Young-Pyo )
단국대학교 의과대학 소아청소년과학교실
송희승 ( Song Hee-Seung )
단국대학교 의과대학 소아청소년과학교실
KMID : 0816120110140010052
Abstract
Purpose: Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema.
Methods: Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction.
Results: 1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p＜0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed.
Conclusion: Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.
키워드
Infant; Low birth weight; Contrast media; Enema; Meconium; Ileus
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