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由于早产儿及围产期窘迫的新生儿存活者增加,以往罕见的新生儿胃肠道穿孔也逐渐增多。作者分析1978～1986年间经手术和尸检确诊的此症患儿48例,男女婴各26及22例,低体重儿38例,早产儿36例。产妇有流产史者11例,胎膜早破及多产各7例,前置胎盘6例,妊高征4例,羊膜炎、羊水过多及胎盘早剥各2例。20例剖腹产及4例胎头吸引或产钳分娩。新生儿窒息21例,动脉导管未闭18例(13例使用消炎痛),肺透明膜病15例,颅内出血3例。穿孔发生前24例婴儿需机械通气,6例经脐动脉输血。21例早产儿因呼吸暂停曾用氨茶硷。30例婴儿在出生后第一周发病,10例在第二周,出生后第5天发病最多。体征以腹胀、呕吐、胃内容物残留、便血、呼吸窘迫,腹壁褪色等多见。亦可有体温过低、呼吸暂停伴心动过缓、低血压、腹泻
Due to the increase of survivors of premature infants and perinatal distress of newborns, gastrointestinal perforation of infants and young infants has also increased in the past. The authors analyzed 48 cases of this disease diagnosed by surgery and autopsy between 1978 and 1986, 26 and 22 cases of male and female infants, 38 cases of low birth weight and 36 cases of premature infants. 11 cases of maternal abortion history, premature rupture of membranes and 7 cases of prolificacy, placenta previa in 6 cases, pregnancy induced hypertension in 4 cases, amniotic inflammation, polyhydramnios and placental abruption in 2 cases. 20 cases of caesarean section and 4 cases of fetal head traction or forceps delivery. Neonatal asphyxia in 21 cases, patent ductus arteriosus in 18 cases (13 cases of indomethacin), 15 cases of hyaline membrane disease, intracranial hemorrhage in 3 cases. Perforation occurred before 24 infants need mechanical ventilation, 6 cases of transvascular umbilical artery. 21 cases of premature children had aminophylline for apnea. Thirty infants developed disease in the first week after birth, 10 in the second week and the fifth day after birth. Signs of bloating, vomiting, residual gastric contents, blood in the stool, respiratory distress, abdominal wall fade and more common. May also have hypothermia, apnea with bradycardia, hypotension, diarrhea