小児消化管穿孔 : 特に新生児消化管穿孔とその予後規定因子について

概要

論文の詳細を見る
The records of 48 patients with gastrointestinal and biliary tract perforations experienced at the Department of Surgery I, Gunma University school of Medicine and the Department of Surgery, Gunma Children's Hospital Medical Center during the period from 1956 to 1983 were analysed. Thirty-four of 48 patients were newborn infants and nine were infants beyond the neonatal period. Anatomic distribution of the perforation showed the small intestine (19 patients), the stomach (12), the large intestine (6), the duodenum and the biliary tract (4 each) in order of frequency. In the remaining three patients, the site of perforation was not identified. An over-all survival rate accounted for 69 per cent. However, during the last 7 year period, a survival rate in newborn infants has been improved from 59 per cent to 71 per cent. The prognosis was closely related to factors such as age at onset, birth weight, etiology and the site of perforation, interval between the onset and definitive treatment, degree of preoperative acidosis and urinary output. However, increased incidence of survivals achieved in the recent years must be mainly due to improved pre- and postoperative care, especially fluid and respiratory control. It is also suggested that the diagnosis in the stage of impending perforation and avoidance of perinatal stress are essential of further improvement of prognosis.
日本小児外科学会の論文
1984-06-20