Gastric Perforation in the Neonate: Clinical Analysis of 12 Cases

新生兒胃穿孔：12病例臨床分析

鍾明宗(Ming-Tsung Chung) ； 郭啟昱(Chii-Yuh Kuo) ； 王榮文(Jung-Wen Wang) ； 謝武勳(Wu-Shiun Hsieh) ； 黃崇濱(Chung-Bin Huang) ； 林哲男(Jer-Nan Lin)

《Acta Paediatrica Sinica》 35卷5期 (1994/10) Pp. 460-465

https://doi.org/10.7097/APS.199410.0460

摘要

胃穿孔是少見的新生兒腹部急症，合併有高死亡率。本文報告長庚醫院過去13年所見之12例新生兒胃穿孔，分析臨床資料，男比女為9比3，常見病徵為腹脹，消化不良，呼吸窘迫和活動力差，所有的病例都在2至5天時出現症狀，X光顯示腹腔積氣，胃穿孔在胃大彎最常見（百分之八十三），在10例病理報告中，有8例是缺血性病變，出血及發炎細胞浸潤，雖然接受手術治療，死亡率仍高達白分之五十八。男性，低鈉血症（血清鈉小於130 meq/1）及代旋性酸血症（PH值小於7.3）是不好的預後因素。本篇報告顯示在新生兒胃穿孔病人之代謝狀況變差之前，做好早期診斷及治療，可能可以改善預後。

關鍵字

胃穿孔 ； 新生兒

並列摘要

Gastric perforation is a rare abdominal catastrophe which associated with high mortality in newborn infants. From June 1978 to July 1991, twelve cases of neonatal gastric perforation presented at Chang Gung Memorial Hospital. Male to female ratio was 9:3. The most common presenting signs were abdominal distension (100%), feeding intolerance (92%), respiratory distress (67%) and poor activity (58%). All cases had significant symptoms between two and five days of age. All of the abdominal plain film showed pneumoperitonium. The most common site of perforation was the great curvature of the stomach (83%). Among the 10 pathological reports available, 8 cases had ischemic change and 2 cases had hemorrhage and inflammatory cell infiltration. There was a high mortality rate of 58% in this series. Male, hyponatremia (serum sodium ＜130 meq/l) and metabolic acidosis (pH＜7.3) were poor prognostic factors. This report suggests that early diagnosis and early management before clinical deterioration of the metabolic status may improve prognosis for neonatal gastric perforation patients.

並列關鍵字

Gastric perforation ； Neonate