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目的:探讨新生儿外科急腹症的病因和影响疗效的因素。方法:对93例新生儿急腹症患儿的临床资料进行回顾性分析。结果:93例中幽门、肠闭锁或狭窄18例、肛门闭锁8例(两者共占28%);坏死性小肠结肠炎15例(16%);先天性肠旋转不良14例(15%)。并发其他畸形或化脓性感染17例。存活77例,死亡16例。胎龄小于36周者病死率为41%(7/17),而足月儿为12%(9/76);出生体重低于2500g者病死率为53%(8/15),大于或等于2500g者为10%(8/78);伴有腹膜炎者为41%(11/27),而无明显腹膜炎者为8%(5/66)。结论:新生儿急腹症的常见病因是先天性消化道畸形和坏死性小肠结肠炎。早产、低出生体重、合并腹膜炎等是影响疗效的主要因素。
Objective: To investigate the etiology of neonates with acute abdomen and the factors influencing the curative effect. Methods: The clinical data of 93 neonates with acute abdomen were retrospectively analyzed. Results: Of the 93 cases, 18 had pyloric or intestinal atresia or stenosis, 8 had anal atresia (both accounted for 28%), 15 had necrotizing enterocolitis (16%), 14 had congenital intestinal malrotation (15%), . 17 cases of other deformities or purulent infection complicated by infection. Survival in 77 cases, 16 deaths. The case fatality rate was 41% (7/17) in gestational age less than 36 weeks and 12% (9/76) in full-term children. The case fatality rate was 53% (8/15) when birth weight was less than 2500g, greater than or equal to 10% (8/78) for 2500g, 41% (11/27) for those with peritonitis, and 8% (5/66) for those with no apparent peritonitis. Conclusions: Common causes of neonatal acute abdomen are congenital gastrointestinal malformations and necrotizing enterocolitis. Preterm birth, low birth weight, combined with peritonitis are the main factors that affect the efficacy.