Obstract Perioperative management strategy for congenital hiatal hernia with anemia.

A 1：1 matched case-control study method was used to collect medical records of 40 children with congenital hiatal hernia complicated with anemia in the People's Hospital of Xinjiang Uygur Autonomous Region from July 2008 to April 2018. Paired t-test was used to compare different perioperative management strategies (group A children with Hb ＞70 g/L, and group B children with Hb ＞90 g/L underwent surgery.) The effect of treatment on congenital hiatal hernia with anemia Impact. Observe and compare the clinical results of the two groups such as age, weight, gender, preoperative hemoglobin (Hb), anemia treatment cost, preoperative nutrition, operative time, intraoperative blood loss, postoperative hospital stay, 3 months postoperative hemoglobin, etc. In group A, there were 4 cases of gastrointestinal bleeding symptoms, 10 cases presented with vomiting as the main complaint, and 10 cases presented with anemia as the main complaint. Among them, 14 were type Ⅰ, 4 were type Ⅱ, and 2 were type Ⅲ; 8 were Uyghur, 7 were Kazakh, and 5 were Han. In group B, 5 cases had gastrointestinal bleeding symptoms, 12 cases presented with vomiting as the main complaint, 8 cases presented with anemia as the main complaint, of which 15 were type Ⅰ, 3 were type Ⅱ, 2 were type Ⅲ, and 5 were Uyghurs. Cases, 15 cases of Han nationality. There was no statistically significant difference in the preoperative data between the two groups (P＞0.05) (Table 1).

There was no statistical difference in the age, weight, sex, and nutritional status of the two groups of children (P＞0.05). All children were given routine treatment to correct anemia before the operation. Suspension red blood cell infusion was performed for all children with anemia. Children in group A were treated with Hb >70 g/L and children in group B were treated with Hb ＞90 g/L. Successfully completed laparoscopic hiatus hernia repair + Nissen fundoplication. The time to correct anemia before operation in group A was (5±1.2) d, and the related expenses were (2200±12.5) yuan, and the time to correct anemia before operation in group B was (8±1.5) d, and the related expenses were (2600±13.4) yuan (P＜0.05) There was no significant difference in the amount of bleeding and the number of days of hospitalization after surgery (P＞0.05). After 3 months of follow-up, there was no significant difference in Hb between the two groups (P＞0.05), and all the children recovered well after the operation without serious complications.

In children with congenital hiatal hernia and anemia, appropriate relaxation of the surgical indications and completion of the operation as soon as possible is an effective measure for the treatment of anemia.