未熟児外科の治療成績(II 重症症例の治療の進歩, 25周年記念シンポジウム論文)

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Ninety-three premature infants (904-2,500g, birth weight) were treated surgically at the Showa University Hospital during the period of 1970-1987. The 93 patiens were divided into two groups : before or after establishment of the NICU (1981) , i. e. 40 patients were in Group A (1971-1980) and 53 in the Group B (1981-1987) . Although there was no significant diffrence of proprotion of the total numbers of premature infants < 2,500g, in each grop period, proprotion of the infants, 1,500g increased in the later period. The overall mortality rate improved significantly in the Group B period (21.2%) , comparing with 39.5% in the Group A period. It is speculated that factors related to the improvement of mortality in the series inclded : 1 ) no death in the patients with congenital intestinal obstruction (n = 18) inclding duodenal obstruction in Group B, comparing with 4 deaths in 15 of those in Group A ; and 2 ) improvement of mortality in esophageal atresia (2/9 in Group B vs. 5/8 in Group A) . Thus, sophisticated cooperation between pediatric surgeons and neonatologists is considered to be important. Despite of progress in diagnostic and therapeutic management in neonatal surgical patients in the recent years, on the other hand, therhand, there were no significant improvement of survival outcome in premature patients with gasrointestinal perforation, diaphragmatic hernia and abdominal wall defect in the series. To enhance survival outcome for these high-risk patients : 1 ) prompt and reliable management for septic patients with gastrointestinal perforation ; and 2 ) improvement of respiratory management for severe pulmonary hypofunction in diaphragmatic hernia are desirable.
日本小児外科学会の論文
1989-10-20

未熟児外科の治療成績(II 重症症例の治療の進歩, 25周年記念シンポジウム論文)

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