新生儿消化道穿孔35例临床分析

目的探讨新生儿消化道穿孔的病因、早期诊断和治疗。方法回顾性分析1990年6月～2005年6月间手术治疗的35例新生儿消化道穿孔的临床特点、穿孔部位、手术方式及转归情况。结果坏死性小肠结肠炎17例,胃壁肌层缺损9例,先天性巨结肠、先天性肠闭锁各2例,肠旋转不良3例,特发性胃穿孔、特发性肠穿孔各1例。第一次手术后治愈25例,死亡8例,2例再次手术治愈。手术治愈率为77.1%。结论早发现、早诊断、早手术可明显降低新生儿消化道穿孔的并发症和病死率。

Diagnosis and Treatment of Gastrointestinal Perforation in 35 Neonates

Objective To investigate the etiology, mechanism, early diagnosis and treatment of neonatal gastrointestinal perforation. Methods Thirty-five neonates with gastrointestinal perforation admitted form June 1990 to June 2005 were reviewed, including the clinical features, perforation location, operative procedures and outcomes. Results There were necrotizing enterocolitis in 17 cases, congenital gastric wall muscular defects in 9 cases, congenital megacolon in 2 cases,intestinal atresia in 2 cases, intestinal malrotation in 3 cases, and idiopathic gastric or intestinal perforation in 1 case respectively. All neonates underwent operation, 27 cases were cured with 2 cases received reoperation, and 8 cases died. The surgical cure rate was 77.1%. Conclusions Early diagnosis and early surgical intervention could obviously decrease complication morbidity and mortality of neonatal gastrointestinal perforation.