新生児術後合併症とその対策

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The report describes operative complications seen in 76 surgical neonates over the past 10 years. The incidence of postoperative complications was 47.4% and postoperative mortality 23.7%. No difference in the incidence of postoperative complications was seen in two groups of the early period (from 1971 to 1975) and the late period (from 1976 to 1980). However, postoperative mortality was significantly low in the late period group(16.1%)comparing with the early period group (45%). The primary causes of death in the 1971-1975 period were pulmonary complication (6 patients), cardiac insufficiency (2) and peritonitis (1). Neonates complicated with respiratory distress before operation died of respiratory or cardiac insufficiency in the early stage of post operative course. Pulmonary problems (6 patients) were the most common complication in the 1976-1980 period, but deaths in the early stage of postoperative course has reduced and recovery from pulmonary complications was seen in some neonates in the late period. In addition, two neonates died of disseninated intravascular coagulopathy and one anastomotic leakage. Factors that have contributed to improvement of results in the late period are early diagnosis and prompt treatment, improvement of surgical treatment for neonates over 2,500g of body weight, choice of staged operation for esophageal atresia, anal atresia and gastroschisis, ventilatory support for prevention and treatment of pulmonary complications and intravenous hyperalimentation.
日本小児外科学会の論文
1982-12-20

新生児術後合併症とその対策

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