新生儿胃穿孔伴肠旋转不良临床特征分析  

Clinical features of neonatal gastric perforation complicated with intestinal malrotation., a report of 12 ca- ses

作　　者：裴洪岗[1] 毛建雄[1] 张翅[1] 李苏伊[1] 

机构地区：[1]深圳市儿童医院外二科普外新生儿外科,518026

出　　处：《中华小儿外科杂志》2013年第4期259-261,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的总结新生儿胃穿孔合并先天性肠旋转不良临床特征。方法回顾我院诊治的12例新生儿胃穿孑L合并肠旋转不良病例，着重将年龄、出生体重、性别、早产、首发症状、穿孔部位、病死率与23例不合并肠旋转不良的胃穿孔病例进行对比分析。结果合并肠旋转不良的新生儿胃穿孔组（NGPM）平均年龄、平均体重、穿孔发生于胃大弯的比例、病死率、首发症状为呕吐比例分别为（4．92±1．08）d、（3．04±0．70）kg、83．3％、50．0％、58．3％，高于不合并肠旋转不良组（NGP）的（4．09±1．73）d、（2．49±0．74）kg、47．80／oo、26．1％、17．4％；NGPM组早产儿比例、性别为男性的比例分别为16．7％、75％，低于NGP组的47．8％、91．3Vo。除首发症状和平均体重外，其他指标差异均无统计学意义。结论合并肠旋转不良的新生儿胃穿孔可能为十二指肠梗阻的一个继发病症，相对不合并肠旋转不良的新生儿胃穿孔患儿，它有部分特有的临床特征。远端消化道梗阻可以导致新生儿胃穿孔，术中探查整个消化道非常必要。Objective To summarize the clinical features of neonatal gastric perforation compli- cated with intestinal malrotation （NGPM）. Methods Twelve patients with NGPM were recruited in this study. The other 23 neonatal gastric perforation patients without malrotation （NGP） were studied as controls. The clinical data including age, birth weight, gender, initial symptom, perforation and mor- tality were retrospectively analyzed to summarize the clinical features of NGPM. Results Compared with the NGP group,the NGPM group had heavier weight （average weight,3.04 ＋ 0. 70 kg vs 2. 49 ＋ 0. 74 kg,P-~0. 05） ,and more frequent vomiting as initial symptom （58. 3o//oo vs 17. 4% ,P^0. 05）. The percentage of premature neonates, male patients, average age at diagnose, and mortality of NGPM group were 16. 7%, 75%, 4. 92 ＋ 1.08 d, and 83.3%, respectively; compared with 47. 8%, 91.3%, 4. 09 ＋ 1.73 d,and 47. 8% in NPG group. Of NGPM group,50. 0% patients had gastric perforation at greater curvature, compared with 26. 1% of NGP group. Among these clinical data, only the differences of average weight and initial symptom frequency were statistically significant between the 2 groups （all P〈0. 05）. Conclusions NGPM is secondary to the obstruction of duodenum. Exploration of the whole digestive tract is recommended.

关 键 词：肠扭转 急腹症 婴儿 新生 

分 类 号：R722[医药卫生—儿科]