Westerik A R, Umans-Eckenhausen M A, Madern G C, Robben S G, van den Anker J N
Afd. Kindergeneeskunde, Academisch Ziekenhuis Rotterdam-Sophia Kinderziekenhuis.
Ned Tijdschr Geneeskd. 1993 Nov 20;137(47):2431-5.
Between August 1989 and August 1992 four neonates with rupture of the liver were admitted to the Neonatal Intensive Care Unit of the Sophia Children's Hospital in Rotterdam, the Netherlands. Two neonates were born after breech delivery, two after caesarean section because of foetal distress. All four patients had Apgar scores < 5 after 1 minute and of < 8 after 5 minutes and required artificial ventilation for a prolonged period. All infants collapsed within 6 hours after birth. Surgical treatment was not considered because of the poor clinical condition. All patients were treated conservatively. Clinical signs were: rapid onset pallor, hypotension, tachycardia and abdominal distension. Ultrasonography of the abdomen confirmed the clinical diagnosis of rupture of the liver. Despite rapid diagnosis and maximal non-surgical treatment mortality was 75%. Surgical intervention is indicated in neonatal liver rupture with significant intra-abdominal bleeding.
1989年8月至1992年8月期间，荷兰鹿特丹索菲亚儿童医院新生儿重症监护病房收治了4例肝破裂新生儿。2例新生儿为臀位分娩后出生，2例因胎儿窘迫行剖宫产术后出生。所有4例患儿1分钟时阿氏评分均<5分，5分钟时均<8分，且需要长时间人工通气。所有婴儿均在出生后6小时内出现病情恶化。由于临床状况不佳，未考虑手术治疗。所有患者均接受保守治疗。临床症状包括：迅速出现面色苍白、低血压、心动过速和腹胀。腹部超声检查证实了肝破裂的临床诊断。尽管诊断迅速且采取了最大程度的非手术治疗，但死亡率仍为75%。对于有明显腹腔内出血的新生儿肝破裂，应进行手术干预。
