Babayigit Aslan, Ozaydın Seyithan, Cetinkaya Merih, Sander Serdar
Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, Turgut Ozal Caddesi No:1 34303 Altınsehir, Kucukcekmece, Istanbul, Turkey.
Department of Pediatric Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Turgut Ozal Caddesi No:1 34303 Altınsehir, Kucukcekmece, Istanbul, Turkey.
Pediatr Surg Int. 2018 Jan;34(1):79-84. doi: 10.1007/s00383-017-4205-1. Epub 2017 Oct 27.
Gastric perforation is a rare condition with high mortality rates in preterm infants. The aim of this retrospective study was to define the risk factors and prognosis in very low birth weight (VLBW) infants with gastric perforations.
VLBW infants with a diagnosis of gastric perforation between 2012 and 2016 were included. The data including birth weight, gestational age, gender, risk factors, time and location of the perforation and prognosis were recorded.
A total of eight infants were identified. The median gestational age and birth weight of the infants were 26 weeks and 860 g, respectively. Five were male and 6 (75%) had a diagnosis of hemodynamically significant patent ductus arteriosus (PDA), early sepsis, persistent hypotension, and drug administration (paracetamol, ibuprofen). The main clinical finding was abdominal distension and pneumoperitoneum was detected in all infants. The median diagnosis was 6 days of life. The median perforation size was 2.5 cm and curvature major and anterior wall were the most common locations. The mortality rate was 62.5%.
Male gender, chorioamnionitis, early sepsis, asphyxia, hemodynamic PDA, persistent hypotension, ibuprofen and paracetamol usage, and orogastric catheter administration were the main risk factors for gastric perforations in VLBW infants.
胃穿孔在早产儿中是一种罕见疾病，死亡率很高。本回顾性研究的目的是确定极低出生体重（VLBW）儿胃穿孔的危险因素及预后情况。
纳入2012年至2016年期间诊断为胃穿孔的VLBW儿。记录的数据包括出生体重、胎龄、性别、危险因素、穿孔时间和部位以及预后情况。
共确定8例患儿。患儿的中位胎龄和出生体重分别为26周和860克。5例为男性，6例（75%）诊断为有血流动力学意义的动脉导管未闭（PDA）、早发型败血症、持续性低血压以及药物使用（对乙酰氨基酚、布洛芬）。主要临床发现为腹胀，所有患儿均检测到气腹。中位诊断时间为生后6天。中位穿孔大小为2.5厘米，胃大弯和前壁是最常见的穿孔部位。死亡率为62.5%。
男性、绒毛膜羊膜炎、早发型败血症、窒息、血流动力学性PDA、持续性低血压、布洛芬和对乙酰氨基酚的使用以及鼻胃管置入是VLBW儿胃穿孔的主要危险因素。
