Clinical analysis of 111 neonates with gastrointestinal perforation / 国际儿科学杂志

ABSTRACT

Objective To explore the cause,clinical manifestation,diagnosis,treatment and prognosis of neonatal gastrointestinal perforation (GIP),for the purpose of improving treatment and prognosis.Methods Clinical data of neonates diagnosed as GIP in our hospital were reviewed retrospectively from 2011 to 2015.The etiology,clinical manifestation and prognosis were evaluated,and multiple-variate analysis was employed to discriminate mortality risk factors.Reanlts One hundred and eleven neonates with complete clinical records were identified.Seventy-six were boys and 35 were girls.Caesarean were more common than vaginal delivery.Preterm neonates were more common than term baby (61 vs.50),and low-birth-weight neonates were more common.Mortality for boys and girls were 19.7％ and 31.6％ respectively (P ＜0.05).Abdominal distention was the most symptoms,and perforation caused by NEC (necrotizing enterocolitis) manifested differently from other perforations.Pneumoperitoneum was reported only in 64％ with plain abdominal x-ray.NEC accounted for most of GIP in our study,and other causes were gastric rupture,intestinal atresia,spontaneous intestinal perforation (SIP) and Hirschsprung's disease.GIP caused by NEC had the highest mortality,but the difference was not significant among groups.Heum was the most common site of perforation.Incision infection was the most postoperative complication.73 ％ infants were cured eventually with an overall mortality rate of 27 ％.Conclusion Main mortality risk factors included gender,weight,respiratory complications,ventilation,etc.,while gestational age,respiratory distress at birth,perforation site and multiple perforations seemed have nothing to do with the mortality.Pneumoperitoneum on plain film is still the first choice of diagnosis.Abdominal ultrasound is useful for the diagnosis of GIP.