Ein S H, Marshall D G, Girvan D
J Pediatr Surg. 1977 Dec;12(6):963-7. doi: 10.1016/0022-3468(77)90607-8.
During 1974 and 1975, five newborn infants weighing between 760 and 1600 g developed severe intraabdominal complications of NEC due to necrotic bowel with perforation and peritonitis. Because these tiny neonates were very ill with sepsis and other severe medical problems, no attempt at laparotomy under general anesthesia was carried out. Instead, using local anesthesia, the contaminated peritoneal cavity was drained via a small incision, usually in the right lower quadrant. This permitted evacuation of air, pus, and stool. In all babies there was improvement evident in the abdomen within one wk, although two of the five newborns died from other causes. The three survivors are well and have normally functioning intestinal tracts 1-2 yr following surgery. One of these surviving babies developed a bowel stricture which subsequently required resection. We feel this method is preferable in the handling of the tiny sick neonate with a bowel perforation from NEC.
在1974年至1975年期间，五名体重在760克至1600克之间的新生儿因坏死性小肠伴穿孔和腹膜炎而发生了严重的坏死性小肠结肠炎腹腔内并发症。由于这些微小的新生儿患有败血症和其他严重的医疗问题，因此未尝试在全身麻醉下进行剖腹手术。相反，采用局部麻醉，通常在右下腹通过一个小切口引流受污染的腹腔。这样可以排出空气、脓液和粪便。所有婴儿在一周内腹部情况均有明显改善，尽管五名新生儿中有两名死于其他原因。三名幸存者情况良好，术后1至2年肠道功能正常。其中一名存活婴儿出现了肠狭窄，随后需要进行切除手术。我们认为这种方法在处理因坏死性小肠结肠炎导致肠穿孔的微小患病新生儿时更为可取。
