新生儿胃穿孔的病因和诊治分析

Analysis of etiology and diagnosis and treatment for stomach perforation in newborns.

目的探讨新生儿胃穿孔的病因、手术方法、综合治疗。方法回顾性分析我院近11年26例新生儿胃穿孔患儿的诊断、治疗和预后。结果2001年以前11例,存活4例,存活率36%,全部切口感染。2002年以来15例,存活11例,存活率73%,切口愈合良好2例,切口红肿4例,切口感染5例。全部成活的15例患儿经半年至11年的随访,除1例患儿出现不全性肠梗阻,其余病例发育正常。结论新生儿胃穿孔部位多位于胃大弯近胃底部,可能同此处的解剖位置和血管分布少有关,早期诊断、合理的手术治疗、以及综合治疗是提高新生儿胃穿孔成活率的重要措施,成活患儿的预后良好。

Objective： To discuss the etiology, operation method, combinded therapy for stomach perforation in newborns. Methods ： Clinical data of 26 cases of stomach perforation in newborns were analyzed retrospectively in - patient at our hospital in the recent 11 years. Results ： Of 11 cases, 4 cases were cured before 2001, the cure rate 36%, there were infection of incisional wound. 11 cases were cured in 15 cases after 2002, the cure rate 73%, 2 cases had good healing of incisional wound, 4 cases appeared wound red swelling, 5 cases had infection of incisional wound. 1 case appeared pero - intestinal obstruction and the rest cases had normo - growth in the 15 cases who were followed up from half a year to 11 years. Conclusions： The location of neonatal gastric perforation invariably located greater curvature of stomach near fundus of stomach, it is related to anatomical position and rare distribution of blood vessel. The important measures to increase the survival rate is early diagnosis, proper operation and combinded therapy. The cured cases eusemia.