Analysis Of Clinical Characteristics And Prognoses In Neonatal Alimentary Tract Perforation

Objective:To explore the clinical characteristics and prognoses in neonatal alimentary tract perforation.Methods:Retrospectively review the 65 clinical datas of neonatus who were confirmed as alimentary tract perforation by operation between January 2015 to December 2016,which contain 43 males and 45 premature infants,contain 7 gastric perforations(group A),34 small intestine perforations(group B),23 colon perforation(group C)and 1 biliary tract perforation(group D).The main clinical manifestations were abdominal distention and pneumoperitoneum.Results:Gastric perforation always occurred at the age of below 5 days.Premature alimentary tract perforation mainly located in small intestine(29,64.4%),and the pathogenies were neonatal necrotizing enterocolitis(NEC,26,57.8%),Hirschsprung's disease(HSCR,5,11.1%)and idiopathic intestinal perforation(4,8.9%),respectively.Term infant alimentary tract perforation mainly located in colon(11,55.0%),and the pathogenies were Hirschsprung's disease(4,20.0%),congenital defects of gastric musculature(4,20.0%),neonatal necrotizing enterocolitis(3,15.0%),respectively.There was no significant difference in distribution among group A,B and C according to birth weight(P>0.05).Preoperative pH value of group B(7.31±0.10)was significantly lower than that of group C(7.38±0.12),preoperative hemoglobin of group C(117.6±31.2)g/L was significantly lower than that of group A(161.1±32.9)g/L and B(137.8±34.5)g/L,there was no significant difference in preoperative lactic acid and albumin(P>0.05)among group A,B and C.4 patients(6.2%)out of 65 were dead,and there were no significant difference in mortality rate with different gestational age,birth weight and perforation site.There were 8 patients with incision infections,and the infection rate was 13.1%.Conclusions:Neonatal alimentary tract perforation often occurred in male premature infants.Premature alimentary tract perforation located mainly in small intestine and the pathogeny mainly was NEC,while term infant alimentary tract perforation located mainly in colon,the pathogenies mainly were HSCR and congenital defects of gastric musculature.The neonatus of alimentary tract perforation can get a favourable prognosis by being active,timely and regular treatment.