Liu Zhaozhou, Zhang Yanan, Sun Dayan, Chen Yongwei, Guo Weihong, Du Jingbin, Huang Jinshi
Department of Neonatal Surgery, Beijing Children Hospital, Capital Medical University, National Center for Children'S Health, 56 Nanlishi Road, Beijing, 100045, China.
Pediatr Surg Int. 2025 Mar 31;41(1):102. doi: 10.1007/s00383-025-05999-8.
Bowel perforation is a severe complication in neonates with Hirschsprung disease (HD), particularly during the neonatal period. Identifying risk factors may aid in early detection and intervention.
We retrospectively analyzed the clinical data of 300 neonates diagnosed with HD at our hospital from 2007 to 2024. The patients were divided into bowel perforation and non-perforation groups based on whether they developed bowel perforation during the neonatal period. The clinical characteristics of both groups were compared. Univariate and multivariate logistic regression analyses were performed to identify the associated risk factors, including general information, clinical symptoms, examination results, and birth history.
A total of 300 neonates with HD were included in this study, with a bowel perforation rate of 6.0% (18/300). The sites of perforation were the sigmoid colon (44.4%, 8/18), descending colon (27.8%, 5/18), ascending colon (11.1%, 2/18), terminal ileum (11.1%, 2/18), and transverse colon (5.6%, 1/18). The results of univariate and multivariate logistic regression analyses revealed that age at admission < 5 days, CRP > 20.5 mg/L, and radiographic findings of intestinal wall pneumatosis were independent risk factors for bowel perforation in neonates with HD, with OR (95% CI) of 4.709 (1.187, 18.684), 35.185 (9.394, 131.782), and 9.667 (2.264, 41.278), respectively.
The incidence of bowel perforation in neonates with Hirschsprung disease is 6.0%. Bowel perforation in neonates with HD is associated with early age at admission, elevated CRP, and intestinal wall pneumatosis.
肠穿孔是先天性巨结肠（HD）新生儿的严重并发症，尤其是在新生儿期。识别危险因素有助于早期发现和干预。
我们回顾性分析了2007年至2024年在我院诊断为HD的300例新生儿的临床资料。根据新生儿期是否发生肠穿孔将患者分为肠穿孔组和非穿孔组。比较两组的临床特征。进行单因素和多因素logistic回归分析以确定相关危险因素，包括一般信息、临床症状、检查结果和出生史。
本研究共纳入300例HD新生儿，肠穿孔发生率为6.0%（18/300）。穿孔部位为乙状结肠（44.4%，8/18）、降结肠（27.8%，5/18）、升结肠（11.1%，2/18）、回肠末端（11.1%，2/18）和横结肠（5.6%，1/18）。单因素和多因素logistic回归分析结果显示，入院年龄<5天、CRP>20.5 mg/L以及肠壁积气的影像学表现是HD新生儿肠穿孔的独立危险因素，OR（95%CI）分别为4.709（1.187，18.684）、35.185（9.394，131.782）和9.667（2.264，41.278）。
先天性巨结肠新生儿肠穿孔发生率为6.0%。HD新生儿肠穿孔与入院年龄小、CRP升高和肠壁积气有关。
