新生儿胃穿孔病因及预后分析

Analysis of etiology and prognosis of neonatal gastric perforation

目的 探讨新生儿胃穿孔病因及预后.方法 回顾性分析18例胃穿孔新生儿性别、胎龄、出生体质量、病程、临床表现、预后.结果 18例患儿男13例,女5例;足月儿8例,早产儿10例;常见的临床表现为精神萎靡、腹胀、呼吸窘迫.所有患儿均行手术治疗,存活率为11/18,预后与胎龄、出生体质量、病程有关（P＜0.05）.结论 新生儿胃穿孔多因先天性胃壁肌层发育缺损所致,病死率高,特别是早产儿.有必要注意患儿的早期诊断、及时手术治疗、加强护理、密切观察病情.

Objective To investigate the etiology,clinical features and prognosis of neonatal gastric perforation.Methods The medical records of 18 patients with neonatal gastric perforation with respect to sex,age,birth-weight,course of disease,clinical presentations,and prognosis were retrospectively analyzed.Results There were 13 boys and 5 girls,8 of whom were full term infants and 10 preterm infants.The most common initial manifestations were poor activity,abdominal distension,and respiratory distress.All neonates were treated by surgical operation,the overall survival rate was 11/18.Prematurity,birth-weight,course of disease,were the statistically significant risk factors （P 〈 0.05）.Conclusions Neonatal gastric perfora tion is mainly caused by congenital gastric wall defect,and associated with high mortality,particularly in premature infants.It is necessary to early diagnosis,surgical operation in time,nurse intensively,and observe the condition closely.