新生儿胃肠道穿孔发病特点及预后分析

CLINICAL FEATURES AND PROGNOSIS OF NEONATAL GASTROINTESTINAL PERFORATION

探讨新生儿胃肠道穿孔发病特点及预后分析 ,对 111例新生儿胃肠道穿孔进行回顾性总结。结果显示 :1 常规腹部X片检查 ,阳性 10 8例。 2 111例中以新生儿坏死性小肠结肠最多见 (2 6 3% ) ,先天性胃肌层缺损 2 4 3% ,其它较常见包括特发性穿孔 ,先天性巨结肠 ,胎粪性腹膜炎及先天性肠闭锁。 3 除先天性胃肌层缺损外 ,原发病及穿孔部位与病死率关系差异无显著性。 4 早产儿有较高病死率 ,围手术期监护及TPN可降低病死率 ,因此 ,新生儿胃肠道穿孔预后与早产、穿孔部位、手术期监护及TPN有密切关系。

To evaluate the prognostic factors and therapeutic results of neonatal gastrointestinal perforations The records of 111 neonates with gastrointestinal perforations were reviewed and analysis by statistic method Results showed:1) 108 out of 111 cases had positive results from the abdominal radiograph 2) Etiologies included necortizing enterocolitis (26 3%), gastric perforation (24 6%), idiopathic intestinal perforation, Hirschsprungs disease,meconium peritonitis and intestinal atresia 3) Mortality for NEC was 10 out of 29 (34 5%) for gastric perforation was 12 out of 27(48%) 4) Premature cases showed a high mortality, perioperation intensive care and TPN can decrease mortality Conclusion: Previewed etiology or the site of perforation and premature infants play a important prognostic role,perioperation intensive care and TPN can improve prognosis.