新生儿呕吐外科原因分析和治疗对策

Analysis of surgical causes and treatment strategies for neonatal vomiting

目的探讨临床新生儿呕吐原因,寻求最佳治疗方法。方法选取2015年1月—2018年9月本院收治的新生儿外科性呕吐80例的临床资料,记录患儿的病因、外科疗效等资料并加以分析。结果外科新生儿呕吐患者的病因包括先天性食管闭锁3例(3. 75%)、腹股沟斜疝嵌顿5例(6. 25%)、先天性巨结肠21例(26. 25%)、幽门肥厚性狭窄15例(18. 75%)、先天性肠闭锁22例(27. 5%)、先天性肛门直肠闭锁5例(6. 25%)、先天性肠旋转不良以及环状胰腺等14例(17. 5%)。由此可见,先天性肠闭锁比例最高,其次为先天性巨结肠,先天性食管闭锁最少。80例患儿中治愈65例,好转8例,死亡3例,自动放弃治疗4例。结论新生儿外科性呕吐的主要病因是先天性消化道畸形。早期诊断与治疗可以提高新生儿呕吐的治愈率。

Objective：To explore the causes of vomiting in clinical neonates and seek the best treatment. Methods： Clinical data of 80 eases of neonatal exogenous vomiting treated in our hospital from January 2015 to September 2018 were selected, and the etiology and surgical efficacy of the children were recorded and analyzed. Results： The surgical patients with neonatal vomiting causes include congenital esophageal atresia 3 eases （3.75 % ）, inguinal hernia, 5 eases （6.25 % ）, congenital megaeolon 21 eases（26.25% ）, pylorie hypertrophic narrow 15 eases（ 18.75% ）, 22 eases（27.5% ） of congenital intestinal atresia, congenital anoreetal atresia in 5 eases （6.25%）, congenital intestinal rotation and 14 eases （ 17. 5% ）, such as annular pancreas. Thus, the proportion of congenital intestinal atresia was the highest, followed by congenital megaeolon, and congenital esophageal atresia was the lowest. Of the 80 eases, 65 were cured, 8 were improved, 3 died and 4 were abandoned automatically. Conclusion： The main cause of neonatal exogenous vomiting is congenital alimentary tract malformation. Early diagnosis and treatment can improve the cure rate of neonatal vomiting.