摘要
嬰兒及孩童之腹水大都因腎臟、肝臟疾病或嚴重心臟衰竭等所引起。新生兒腹水較為罕見且病因也大不相同。馬偕小兒科從1981~1985五年中共經歷16例新生兒腹水病例。男、女各8例。14例一出生就有明顯腹水。另有2例其腹水分別在出生後第8及18天才發生。完其病因，胎糞性腹膜炎5例，因感染引起者4例（其中3例為先天性梅毒感染，1例為早產兒合併白色念珠菌敗血症），乳糜性腹水、先天性心臟病、尿液性腹水及無水腫性血紅素Bart's症候羣各1例。其餘3例病因不明。11例死亡，死亡率達68.8%。
關鍵字
無資料並列摘要
The presence of neonatal ascites was easily confirmed but the causes were often difficultly discovered. In the past 5 years (1981-85), 16 cases of massive ascites in the neonatal period were reviewed. Three groups of the patients were excluded in this report: 1. hydrops fetalis, 2. the patients whose ascites were discovered at the operation, 3. the ascites were associated with prominent Roentgen sign of gastrointesinal obstruction or perforation. The ascites were found immediately after birth in 14 cases. In another 2 cases, the ascites were found at the age of 8 days and 18 days respectively. Male and female were equal in number. The causes of neonatal ascites were as the following: meconium peritonitis in 5 cases, congenital syphilis in three, candidiassis, lymphangiectasia, cardiac malformation, urinary ascites and nonhydrops Hb Bart's syndrome all in one respectively. In other 3 cases the etiology was unknown. Meconium peritonitis and congenital syphilis were the most common causes of neonatal ascites. It was different from the literature, in which urinary ascites was the leading cause. Hb Bart's syndrome with massive ascites and hepatomgaly but without hydrops fetalis was never reported in other literature. 11 cases died. The mortality rate was high as 68.8%. The management was relied on the better undertanding of the pathophysiologic mechanisms of neonatal ascites. Antenatal diagnosis, liberal use of cesarean section for preterm delivery before development of gross ascites, and early transfer to a high risk pernatal unit for immediate neonatal resuscitation will decrease the mortality. Ultrasonographic evaluation and genetic counseling also play an important role in the management.