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目的:分析新生儿单纯性结肠穿孔的诊断、治疗、预后。方法:回顾性分析17例经手术证实的单纯性结肠穿孔患儿临床资料。结果:本组治愈16例,1例死于肺炎、代谢紊乱并呼吸衰竭。17例均采用单纯肠穿孔修补术;术前胸腹X线立位片14例诊断肺炎,11例见膈下游离气体,诊断肠穿孔,6例见液气平,为肠梗阻。术后加强监护及静脉高营养;根据腹腔液细菌培养结果选择三代头孢菌素抗感染。结论:对新生儿单纯性肠穿孔临床早期诊断,及时手术,有效抗生素应用,正确围手术期处理及静脉高营养是治愈的关键;出生时是否足月、感染、内环境是否稳定是影响新生儿肠穿孔预后的重要因素。
Objective: To analyze the diagnosis, treatment and prognosis of simple colonic perforation in neonates. Methods: A retrospective analysis of 17 cases of surgically confirmed children with colonic perforation clinical data. Results: The group was cured in 16 cases, one died of pneumonia, metabolic disorders and respiratory failure. All the 17 cases were treated by simple bowel perforation repair. 14 cases of pneumothorax were diagnosed by X-ray of chest and abdomen before operation, 11 cases were found with free gas under the diaphragm, and intestinal perforation was diagnosed. Postoperative intensive care and intravenous nutrition; according to the results of bacterial culture of peritoneal fluid selection of third-generation cephalosporin anti-infective. Conclusions: Early clinical diagnosis, timely operation, effective antibiotic application, proper perioperative management and intravenous high nutrition are the key to cure neonatal simple intestinal perforation. Whether or not born at term, infection and stable internal environment are the key factors affecting newborn infants Prognosis of intestinal perforation of the important factors.