- 期刊
Bilious Vomiting During the First Week of Life
一週內新生兒之膽汁性嘔吐
摘要
自1988年11月到1991年11月間，馬偕醫院小兒科有45例病人，因爲出生一週內發生膽汁性嘔吐而住院。其中23例(51.1%)需要外科療法，22例(48.8 %)不需要外科治療。臨床上如有綠色嘔吐物、腹脹、昏睡、易怒，觸診時腹部疼痛等，則這種病人傾向於需要外科手衍治療。但是嘔吐時間或第一次胎便排出的早晚，則無法用來判斷是否需要外科療法。例是剛住院時腹部x光檢查對鑒別診斷很有幫助，16例腹部X光檢查正常的病人都不需要手衍治療，23例有特殊影像發現的，其中19例(82.6%)需要外科治療。腹部X光檢查發現有完全腸胃阻塞、腸胃道破裂或腹膜炎，就應行手前治療而不必再進一步作腸胃道灌鋇監檢查。否則當腹部X光檢查發現不正常或臨床上沒進步時，就需要淮一步作腸胃道灌鋇監檢查。
關鍵字
無資料並列摘要
From Nov. 1988 to Nov. 1991, forty-five newborns, who were admitted due to bilious vomiting within the first 7 days of life followed prospectively. Twenty-three (51.1%) required surgical intervention, and the remaining twenty-two (48.9%) had nonsurgical conditions. Clinical findings of green vomitus, abdominal distension, lethargy, irritability and abdominal tenderness are more likely to indicate the need for surgery. But the onset of vomiting and time of first stool passage are not helpful in detecting the need for surgery situation. Initial routine plain abdominal roentgenogram is helpful in distinguishing infants with surgical or nonsurgical problems. Sixteen infants with normal plain abdominal roentgeno grams had nonsurgical conditions. Specific findings on the plain abdominal roentgenogram were noted in 23 infants, and 19 (82.6%) of these needed surgical intervention. Contrast studies were indicated for those without signs of complete obstruction, perforation or peritonitis, but the plain abdominal roentgeno gram was abnormal and clinical condition did not improved.