早产儿自发性肠穿孔5例临床特征分析  

Clinical characteristics of spontaneous intestinal perforation in 5 casesof premature infants

作　　者：李亮亮[1] 李苗苗[1] 王雯雯[1] 卞春晖 姜红[1] 李向红[1] LI Liangliang;LI Miaomiao;WANG Wenwen;BIAN Chunhui;JIANG Hong;LI Xianghong(Department of Neonatology,the Affiliated Hospital of Qingdao University,Shandong Qingdao 266000,China)

机构地区：[1]青岛大学附属医院新生儿科,山东青岛266000

出　　处：《中国妇幼健康研究》2020年第10期1374-1378,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析早产儿自发性肠穿孔(SIP)的临床表现及特征,以进一步认识早产儿SIP的发病特点,为临床诊治提供参考。方法总结2013年6月至2019年6月在青岛大学附属医院手术治疗的符合SIP诊断的5例患儿,回顾性分析肠穿孔的特点及手术特征。结果4例患儿为体重低于1000g的超低出生体重儿,1例为体重低于1500g的极低出生体重儿。3例穿孔处位于距离回盲部10~40cm回肠位置,2例为距离Treiz韧带15~40cm空肠位置。4例患儿为单发肠穿孔,直径为0.2~1cm,1例患儿出现2处穿孔。5例患儿均进行肠修补,1例患儿术后并发肺出血死亡,其余4例均预后良好。结论早产儿SIP多发生于超低出生体重儿,肠管病变较为局限,病变多限于穿孔及临近穿孔处肠管外,多为单发穿孔。实施肠道修补治疗,预后多数较好。Objective To analyze the clinical manifestations and characteristics of spontaneous intestinal perforation(SIP)in premature infants,so as to further understand the pathogenesis characteristics of SIP in premature infants and provide reference for clinical diagnosis and treatment.Methods Five cases of patients who were diagnosed with SIP and underwent surgical treatment in the Affiliated Hospital of Qingdao University from June 2013 to June 2019 were summarized.The characteristics of intestinal perforation and surgical features of them were retrospectively analyzed.Results Four cases were extremely low birth weight infants weighing less than 1000 g,and one case was very low birth weight infants weighing less than 1500 g.The perforation sites were 10-40 cm from ileocecal part in three cases and 15-40 cm from flexor ligament in two cases.Four cases had single intestinal perforation with a diameter of 0.2-1 cm,and one child presented with two perforations.Five patients all underwent intestinal repair,one case died of pulmonary hemorrhage after operation,and the other four cases all had good prognosis.Conclusion SIP in premature infants mostly occurs in extremely low birth weight infants,and intestinal lesions are more limited.The lesions are mostly confined to perforation and adjacent perforation outside of the intestinal canal,and most of which were single perforation.The prognosis of intestinal repair is good in most cases.

关 键 词：早产儿 超低出生体重儿 自发性肠穿孔 外科手术 

分 类 号：R722.6[医药卫生—儿科]