【摘要】：目的分析新生兒胃腸穿孔的病因、臨床特征、治療及預(yù)后。方法回顧性分析2004年1月至2015年12月復(fù)旦大學(xué)附屬兒科醫(yī)院新生兒科收治的80例新生兒胃腸穿孔患兒的臨床資料,根據(jù)出生胎齡分為早產(chǎn)兒組與足月兒組,比較兩組間的病因、臨床表現(xiàn)、治療及預(yù)后。結(jié)果 80例新生兒胃腸穿孔中,早產(chǎn)兒62例,足月兒18例。兩組病因均以壞死性小腸結(jié)腸炎(necrotizing enterocolitis,NEC)為主,臨床均以腹脹為主要表現(xiàn),早產(chǎn)兒發(fā)生反應(yīng)差、休克、彌散性血管內(nèi)凝血明顯多于足月兒(P0.05)。早產(chǎn)兒組平均發(fā)病日齡9(1.75,20)d,足月兒組平均發(fā)病日齡4.5(1,7.75)d。62例手術(shù)治療,其中胃穿孔8例,腸穿孔54例,18例因未手術(shù)穿孔部位不明確。死亡32例,病死率40%,早產(chǎn)兒死亡26例(病死率41.9%),足月兒死亡6例(病死率33.3%)。結(jié)論新生兒胃腸穿孔是新生兒期的嚴(yán)重疾病,病死率高。早期診斷、積極治療和盡早外科干預(yù)可能提高患兒的存活率,顯著改善患兒的預(yù)后。
[Abstract]:Objective to analyze the etiology, clinical features, treatment and prognosis of neonatal gastrointestinal perforation. Methods the clinical data of 80 newborns with gastrointestinal perforation were analyzed retrospectively from January 2004 to December 2015 in the Department of Neonatrics, affiliated Pediatrics Hospital of Fudan University. According to the gestational age, they were divided into premature group and term group. The etiology of the two groups was compared. Clinical manifestation, treatment and prognosis. Results among 80 cases of neonatal gastrointestinal perforation, 62 cases were premature and 18 cases were full-term. The main etiology of the two groups was necrotizing enterocolitis (necrotizing enterocolitis,NEC). Abdominal distension was the main clinical manifestation. Premature infants had poor response shock and disseminated intravascular coagulation were significantly more than full-term infants (P0.05). The average onset age of premature infants was 9 (1.75 ~ 20) days, and that of term infants was 4.5 (1 / 7.75) d.62. There were 8 cases of gastric perforation and 54 cases of intestinal perforation. There were 32 cases of death, 40 cases of death rate, 26 cases of premature infant death (41.9%) and 6 cases of term infant death (33.3%). Conclusion Neonatal gastrointestinal perforation is a serious disease in neonatal stage with high mortality. Early diagnosis, active treatment and early surgical intervention may improve the survival rate and prognosis of children.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院新生兒科;
【分類號】：R722.1

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