新生儿胃肠道穿孔33例临床分析

Clinical analysis of thirty-three cases of neonatal gastrointestinal perforation

目的：提高新生儿胃肠道穿孔的诊断、治疗水平，降低病死率。方法：回顾分析１９９１年至１９９９年新生儿胃肠道穿孔 ３３例的诊断、治疗，其中男 ２２例，女 １１例。坏死性小肠结肠炎穿孔 １３例，胃穿孔 ９例。先天性巨结肠伴结肠炎结肠穿孔 ２例，１例盲肠穿孔。美克耳憩室炎穿孔 ２例，另嵌疝复位后穿孔 １例，肠闭锁穿孔２例。不明原因穿孔３例。结果：痊愈１８例，占５４．５％（１８／３３），死亡１０例，占３０％（１０／３３）， ５例放弃。结论：早期诊断、围手术期处理、手术治疗是降低病死率的关键。

Objective: To improve the diagnosis and treatment level and to decrease the mortality of neonatal gastrointestinal perforation. Methods: To analyse thirty-three cases of neonatal gastrointestinal perforation from 1991to 1999. Twenty-two boys and eleven girls are retrospected. Among them,thirteen are perforation of NEC, nine are gastric perforation , two are congenital megacolon accompanying colonic perforation of colitis, one is cecum perforation.Two are Meckels diverticulitis perforation and two due to perforation of intestinal atresia respectively. Perforation of incarcerated hernia after reposition is found in one case. Three are unknown for the cause of perforation. Results: The cure rate is 54.5%,mortality rate is 33.3%(10/33), and five out of thirty-three were given up for treatment. Conclusion: The key to decrease the mortality is early diagnosis, perioperation treatment and operation.