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目的总结新生儿胃穿孔的病因、诊断和治疗方法。方法回顾性分析2009年8月-2014年8月收治的新生儿胃穿孔的临床资料,总结分析胃穿孔的诊断、治疗和预后情况。结果共纳入11例患儿,发病年龄2~7 d,其中足月儿8例,早产儿3例;男4例,女7例;出生体质量在1 680~3 800 g。所有患儿均给予手术治疗,且经手术证实为胃穿孔。穿孔部位:胃大弯8例,胃小弯3例。其中1例术后死于多脏器功能衰竭,1例合并肠旋转不良、肠管大部分坏死,家长放弃治疗,存活9例,存活率81.8%,存活患儿经6个月~5年的随访,均生长发育正常。结论新生儿胃穿孔可能由多种原因所致,其中胃壁先天发育缺陷是最常见的原因;及早诊断、早期积极手术治疗以及新生儿重症监护室和新生儿外科的密切配合是基层医院提高新生儿胃穿孔存活率的重要措施。
Objective To summarize the etiology, diagnosis and treatment of neonatal gastric perforation. Methods The clinical data of neonatal gastric perforation admitted from August 2009 to August 2014 were retrospectively analyzed. The diagnosis, treatment and prognosis of gastric perforation were summarized. Results A total of 11 children were enrolled in this study. The age of onset was from 2 to 7 days. Among them, 8 were full-term infants and 3 were premature infants. There were 4 males and 7 females with a birth weight of 1 680-3 800 g. All children were given surgical treatment, and confirmed by surgery for gastric perforation. Perforation site: stomach big bend in 8 cases, 3 cases of gastric curvature. One case died of multiple organ failure after surgery, one case had combined bowel malrotation and the bowel was mostly necrotic. Parents abandoned treatment and survived in 9 cases with a survival rate of 81.8%. Survival children were followed up for 6 months to 5 years , Are normal growth and development. Conclusion Gastric perforation in neonates may be caused by a variety of reasons, of which the congenital defects in the stomach wall are the most common causes; early diagnosis, early aggressive surgery and the close cooperation between neonatal intensive care unit and neonatal surgery are the primary hospitals to improve newborns Important measure of gastric perforation survival rate.