Mediciones ecográficas, cloro y bicarbonato sérico como predictor de vómitos posoperatorios en pacientes con estenosis hipertrófica del píloro
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2023
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: La Estenosis Hipertrófica del Píloro (EHP) es la causa más común de obstruccióndel tracto de salida gástrico en lactantes menores reportándose una prevalencia de 1 – 4 por cada 1000 nacidos vivos. Afortunadamente tiene tratamiento resolutivo que es la Piloromiotomía. Complicaciones postoperatorias como el vómito puede estar presente entre el 2 - 26%, asociado amúltiples factores, así como las alteraciones electrolíticas en sangre y mediciones ecográficas delpíloro anormales en la etapa preoperatoria. Objetivo: Determinar la utilidad de las mediciones ecográficas, cloro y bicarbonato sérico como predictor de vómitos postoperatorios en pacientes con EHP. Metodología: Se realizó un estudio correlacional, no experimental, transversal, retro prospectivo en pacientes con diagnóstico de EHP que han sido intervenidos quirúrgicamente, en el Hospital Francisco Icaza Bustamante desde enero del 2019 a diciembre del 2021. Para el análisisestadístico de variables se utilizó la prueba de Chi Cuadrado, con nivel de confianza de 95% y p 0,05. Además, se utilizó el programa SPSS v25 (Statistical Package for the Social Sciencies); paralas variables categóricas se utilizó estadística descriptiva según corresponda su distribución(prueba de Shapiro-Wilk); mediante estadística inferencial con coeficiente de correlación de Pearson se analizó la asociación existente entre las variables. Resultados: Se estudiaron 50 pacientes de los cuales 9 presentaron vómitos postoperatorios, y se obtuvo una relación significativa pero débil con valores del cloro mayor a 96 mmol y una asociación fuerte positiva con el diámetro del píloro y la presencia de vómitos. Conclusiones: El cloro sérico y diámetro delpíloro fueron factores determinantes con una significancia estadística ante la presencia de vómitospostoperatorios, estos datos difieren con resultados de otras literaturas, lo que sugiere se deben realizar más estudios con mayor población e interinstitucional. Palabras clave: Estenosis Hipertrófica del Píloro, vómitos, cloro y bicarbonato sérico, medicionesecográficas del píloro.
Introduction: Hypertrophic Pyloric Stenosis (HPS) is the most common cause of gastric outlet obstruction in young infants, reporting a prevalence of 1-4 per 1000 live births. Fortunately, he hasa resolving treatment that is Pyloromyotomy. Postoperative complications such as vomiting may be present in 2-26%, associated with multiple factors, as well as electrolyte abnormalities in the blood and abnormal ultrasound measurements of the pylorus in the preoperative stage. Objective:To determine the usefulness of ultrasound, chloride and serum bicarbonate measurements as a predictor of postoperative vomiting in patients with HPD. Methodology: A correlational, non- experimental, cross-sectional, retrospective study was carried out in patients diagnosed with HPDwho have undergone surgery at the Francisco Icaza Bustamante Children's Hospital from January2019 to December 2021. For the statistical analysis of variables, the Chi Square test was used, witha confidence level of 95% and p value 0.05. In addition, the SPSS v25 program (Statistical Packagefor the Social Sciences) was used; for categorical variables, descriptive statistics were used according to their distribution (Shapiro-Wilk test); Using inferential statistics with Pearson's correlation coefficient, the association between the variables was analyzed. Results: 50 patients were studied, 9 of whom presented postoperative vomiting, and a significant but weak relationshipwas obtained with chlorine values greater than 96 mmol and a strong positive association with thediameter of the pylorus and the presence of vomiting. Conclusions: Serum chloride and pylorus diameter were determining factors with statistical significance in the presence of postoperative vomiting, these data differ with results from other literatures, which suggests more studies shouldbe carried out with larger populations and interinstitutional. Key words: Hypertrophic Pyloric Stenosis, vomiting, serum chloride and bicarbonate, ultrasonographic measurements of the pylorus.
Introduction: Hypertrophic Pyloric Stenosis (HPS) is the most common cause of gastric outlet obstruction in young infants, reporting a prevalence of 1-4 per 1000 live births. Fortunately, he hasa resolving treatment that is Pyloromyotomy. Postoperative complications such as vomiting may be present in 2-26%, associated with multiple factors, as well as electrolyte abnormalities in the blood and abnormal ultrasound measurements of the pylorus in the preoperative stage. Objective:To determine the usefulness of ultrasound, chloride and serum bicarbonate measurements as a predictor of postoperative vomiting in patients with HPD. Methodology: A correlational, non- experimental, cross-sectional, retrospective study was carried out in patients diagnosed with HPDwho have undergone surgery at the Francisco Icaza Bustamante Children's Hospital from January2019 to December 2021. For the statistical analysis of variables, the Chi Square test was used, witha confidence level of 95% and p value 0.05. In addition, the SPSS v25 program (Statistical Packagefor the Social Sciences) was used; for categorical variables, descriptive statistics were used according to their distribution (Shapiro-Wilk test); Using inferential statistics with Pearson's correlation coefficient, the association between the variables was analyzed. Results: 50 patients were studied, 9 of whom presented postoperative vomiting, and a significant but weak relationshipwas obtained with chlorine values greater than 96 mmol and a strong positive association with thediameter of the pylorus and the presence of vomiting. Conclusions: Serum chloride and pylorus diameter were determining factors with statistical significance in the presence of postoperative vomiting, these data differ with results from other literatures, which suggests more studies shouldbe carried out with larger populations and interinstitutional. Key words: Hypertrophic Pyloric Stenosis, vomiting, serum chloride and bicarbonate, ultrasonographic measurements of the pylorus.
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ESTENOSIS HIPERTROFICA DEL PILORO, NAUSEA Y VOMITO POSOPERATORIOS, PEDIATRIA, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTON GUAYAQUIL, ECUADOR, EQUILIBRIO ACIDO-BASE, ULTRASONOGRAFIA