新生兒壞死性腸炎之外科治療

Surgical Management of Neonatal Necrotizing Enterocolitis

張北葉(Pei-Yeh Chang) ； 陳秋江(Chiu-Chiang Chen)

《Acta Paediatrica Sinica》 27卷2期 (1986/04) Pp. 128-134

摘要

新生兒壞死性炎在臺灣日漸受到重視，本篇作者能就臺大醫院近十年來因此病施行手術之患者加以分析，發現這些病嬰足月順産並且體重正常者居多，發病時間較晚，病程進行較緩，但由於診斷的延誤及不適當的治療，死亡率仍高達一半。吾人認爲本症之治療應以積極而嚴密的保守療法爲主，手術應有嚴格之指徵並需充分之術前凖備。手術方式依病人之病程及個別狀況而定，但以簡單有效爲原則。經保守療法或開刀後存活的病人應防可能發生腸阻塞或腸瘻等後期併發症。

並列摘要

During the period 1975-4984, 22 newborns with necrotizing enterocolitis were surgically treated at the Department of Surgery, National Taiwan University Hospital by one of the authors (CC Chen). The majority of cases were full term babies, spontaneously delivered, with normal birth weight. The symptoms of necrotizing enterocolitis appeared relatively late, at an average three weeks of age, and the majority of cases led a relatively slowly progressive course compared with similar cases in Caucasians.
The survival rate after operation in this series was 50%. High mortality was encountered with those acute cases in which conservative measures had not been timely or properly instituted before operation. Therefore, with the exceptions of free perforation and complete intestinal obstruction, progressive deterioration of vital signs and abdominal findings after intensive conservative treatment seemed to be the only indication for surgical intervention.

並列關鍵字

necrotizing enterocolitis ； newborn ； acute abdomen