Background: The outcome of neonatal surgery depends on safe anaesthesia, competent surgery and good nursing care. The University of Uyo Teaching Hospital, Uyo, Nigeria, established in February 2008, has specialist ana...Background: The outcome of neonatal surgery depends on safe anaesthesia, competent surgery and good nursing care. The University of Uyo Teaching Hospital, Uyo, Nigeria, established in February 2008, has specialist anaesthetic and surgical manpower. The aim of the study was to determine the outcome and contributing factors to mortality in neonatal surgical emergencies at this new tertiary health institution. Method: It was a retrospective descriptive study of neonates that underwent emergency surgery at the University of Uyo Teaching Hospital between June 2008 and May 2011. Data was obtained from the anaesthetic register, ward admission and discharged register, nurses report books and patient case files. Results: Forty-five neonates were operated upon during the three year period. There were 28 males and 17 females with a male to female ratio of 1.7:1. Forty-four (97.8%) of the neonates were referred to the University of Uyo Teaching Hospital. The mean age and body weight at presentation were 47.5 ± 44.4 hours and 2.65 ± 0.61 kg respectively. The mean interval between admission and surgical intervention was 4.9 ± 6.2 days. Malformations of the gut (40%) and anterior abdominal wall (26.7%) were the major pathologies. The overall mortality following surgery was 62.2%. Case fatality rates ranged from 0% for Hirschprung’s disease to 100% for tracheoesophageal fistula. The immediate causes of death among these neonates were peritonitis from gangrenous gut, hypovolaemia and repeat surgery. Contributing factors to mortality were delivery in unorthodox health facilities, delay in presentation as well as surgical intervention and inefficient postoperative monitoring. Conclusion: Emergency neonatal surgeries at the UUTH are associated with unacceptable high mortality. Reduction in such mortality would require campaign for early presentation, a lot more timely surgical interventions and upgrading of monitoring facili- ties to help in improving perioperative monitoring and care.展开更多
2020年5月8日,欧洲加速康复外科(enhanced recovery after surgery,ERAS)协会首次发布了《新生儿肠道手术围术期监护共识指南》,该指南针对新生儿肠切除手术提供了17条ERAS建议,内容涵盖术式选择、预防性应用抗生素、防止术中体温过低...2020年5月8日,欧洲加速康复外科(enhanced recovery after surgery,ERAS)协会首次发布了《新生儿肠道手术围术期监护共识指南》,该指南针对新生儿肠切除手术提供了17条ERAS建议,内容涵盖术式选择、预防性应用抗生素、防止术中体温过低、围术期液体管理、镇痛、最优血红蛋白阈值、围术期沟通、家长的参与、术后早期营养护理和肠液回输10个方面。该指南旨在为新生儿肠道外科提出ERAS建议以减少围术期不良事件,提高医疗质量及家属满意度。现对其进行解读,以期为我国新生儿外科的围术期管理实践提供最新的指南依据。展开更多
文摘Background: The outcome of neonatal surgery depends on safe anaesthesia, competent surgery and good nursing care. The University of Uyo Teaching Hospital, Uyo, Nigeria, established in February 2008, has specialist anaesthetic and surgical manpower. The aim of the study was to determine the outcome and contributing factors to mortality in neonatal surgical emergencies at this new tertiary health institution. Method: It was a retrospective descriptive study of neonates that underwent emergency surgery at the University of Uyo Teaching Hospital between June 2008 and May 2011. Data was obtained from the anaesthetic register, ward admission and discharged register, nurses report books and patient case files. Results: Forty-five neonates were operated upon during the three year period. There were 28 males and 17 females with a male to female ratio of 1.7:1. Forty-four (97.8%) of the neonates were referred to the University of Uyo Teaching Hospital. The mean age and body weight at presentation were 47.5 ± 44.4 hours and 2.65 ± 0.61 kg respectively. The mean interval between admission and surgical intervention was 4.9 ± 6.2 days. Malformations of the gut (40%) and anterior abdominal wall (26.7%) were the major pathologies. The overall mortality following surgery was 62.2%. Case fatality rates ranged from 0% for Hirschprung’s disease to 100% for tracheoesophageal fistula. The immediate causes of death among these neonates were peritonitis from gangrenous gut, hypovolaemia and repeat surgery. Contributing factors to mortality were delivery in unorthodox health facilities, delay in presentation as well as surgical intervention and inefficient postoperative monitoring. Conclusion: Emergency neonatal surgeries at the UUTH are associated with unacceptable high mortality. Reduction in such mortality would require campaign for early presentation, a lot more timely surgical interventions and upgrading of monitoring facili- ties to help in improving perioperative monitoring and care.
文摘2020年5月8日,欧洲加速康复外科(enhanced recovery after surgery,ERAS)协会首次发布了《新生儿肠道手术围术期监护共识指南》,该指南针对新生儿肠切除手术提供了17条ERAS建议,内容涵盖术式选择、预防性应用抗生素、防止术中体温过低、围术期液体管理、镇痛、最优血红蛋白阈值、围术期沟通、家长的参与、术后早期营养护理和肠液回输10个方面。该指南旨在为新生儿肠道外科提出ERAS建议以减少围术期不良事件,提高医疗质量及家属满意度。现对其进行解读,以期为我国新生儿外科的围术期管理实践提供最新的指南依据。
