Chen An, Du Jing, Du Li-Zhong
Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Dec;15(12):1074-8.
Abdominal distention is a common disorder in newborns, which can be life-threatening in severe cases. Currently, little literature is available regarding early identification of the etiology of this disorder in newborn babies, which is imperative to reducing the likelihood of serious consequences. This retrospective study was conducted to analyze the clinical characteristics of early newborns with abdominal distention, aiming at identifying the underlying etiologic factors.
Medical records of 201 (65 premature and 136 full-term) early newborns with abdominal distention between January 2011 and December 2012 were retrieved.
Congenital malformations (including congenital megacolon, anal atresia, malrotation, intestinal atresia, intestinal duplication and posterior urethral valves) occurred in 44.6% of the premature newborns with abdominal distention and 61.8% of the full-term newborns with the disorder. Congenital megacolon was the number one cause of abdominal distention in the full-term group (33.8%) and the number two cause in the preterm group (13.8%). As far as other individual abnormalities were concerned, sepsis was the number one cause of abdominal distention in the preterm group (35.4%) and the number two cause in the full-term group (21.3%). Vomiting was a main symptom associated with abdominal distension, occurring in 64.0% of the full-term newborns and 44.6% of the preterm newborns. The most pronounced X-ray manifestation was bowel distention with an air-fluid level in the preterm group (47.7%) but was bowel distention without a fluid level in the full-term group (57.3%). Eliological and symptomatic treatment was effective in 86.2% of the premature cases and 88.2% in the full-term cases (P>0.05).
Congenital malformations may be the major cause of abdominal distension in early newborns. Sepsis and congenital megacolon are the single disease most frequently associated with abdominal distention in preterm and full-term newborns respectively. Vomiting is a main accompanying symptom in early newborns with abdominal distention. X-ray manifestations seem to be more severe in preterm newborns than in full term newborns. A satisfactory outcome can be achieved after treatment in both preterm and full-term newborns with this disorder.
腹胀是新生儿常见病症,严重时可危及生命。目前,关于新生儿该病症病因早期识别的文献较少,而这对于降低严重后果发生的可能性至关重要。本回顾性研究旨在分析早期腹胀新生儿的临床特征,以确定潜在病因。
检索2011年1月至2012年12月期间201例(65例早产儿和136例足月儿)早期腹胀新生儿的病历。
先天性畸形(包括先天性巨结肠、肛门闭锁、肠旋转不良、肠闭锁、肠重复畸形和后尿道瓣膜)在腹胀早产儿中占44.6%,在腹胀足月儿中占61.8%。先天性巨结肠是足月儿组腹胀的首要原因(33.8%),是早产儿组腹胀的第二大原因(13.8%)。就其他个体异常而言,败血症是早产儿组腹胀的首要原因(35.4%),是足月儿组腹胀的第二大原因(21.3%)。呕吐是与腹胀相关的主要症状,在足月儿中发生率为64.0%,在早产儿中发生率为44.6%。最明显的X线表现是早产儿组肠扩张伴气液平面(47.7%),而足月儿组是肠扩张无液平面(57.3%)。病因及对症治疗在86.2%的早产病例和88.2%的足月病例中有效(P>0.05)。
先天性畸形可能是早期新生儿腹胀的主要原因。败血症和先天性巨结肠分别是早产儿和足月儿腹胀最常相关的单一疾病。呕吐是早期腹胀新生儿的主要伴随症状。早产儿的X线表现似乎比足月儿更严重。患有该病症的早产儿和足月儿经治疗后均可取得满意疗效。