Study On Clinical And Etiological Analysis In Neonatal Gastrointestinal Perforation

ObjectiveTo analyze and summarize the clinical and etiology characteristics of neonatal gastrointestinal perforation,and guide clinical diagnosis and treatment.MethodsThe general condition,clinical manifestation,etiology,treatment and prognosis of 95 patients were analyzed retrospectively.Results(1)95 cases of neonatal gastrointestinal perforation of the main clinical manifestations were abdominal distension(85 cases,89.47%)and vomiting(55 cases,57.89%),only 32.63%(31 cases)with abnormal temperature,main abdominal sign was abdominal distention(85 cases,89.47%),otherwise,peritoneal irritation(52 cases,54.74%),abdominal wall vein engorgement(44 cases and 46.32%)were the common signs;(2)Most of the perforated segments were intestine(45 cases,47.37%)and colon(40 cases,42.11%),gastric perforation was 10.53%(10 cases),the common segment of intestine perforation was ileum(33 cases,73.33%),the common segment of colon perforation was ileum transverse colon(11 cases,27.50%);(3)In 95 patients,61 cases collected abdominal exudatives for bacterial culture and drug sensitivity test,46 cases positive,53 strains of pathogenic bacteria were obtained,gram negative bacteria was 40 strains(75.47%).The main pathogenic bacteria were Klebsiella pneumoniae pneumoniae in 37.5%(15 strains)and Escherichia coli in 30%(12 strains);gram positive bacteria ware 13 strains,including Enterococcus faecium(53.85%),Staphylococcus epidermidis(23.08%)and Enterococcus faecalis(15.38%);(4)The purpose of operation was to save life.General physical condition and perforated segments were comprehensive analysis.The simple and effective operation was done and the common operation was enterostomy.Clinical cure rate was 82% and had a better prognosis.ConclusionsThe clinical manifestation of Neonatal gastrointestinal perforation were atypical,unexplained abdominal distension with vomiting and fever,combined with abdominal signs should be thought about the possibility of gastrointestinal perforation.Abdominal radiograph show pneumoperitoneum to definite diagnosis;Gram negative bacteria was the main pathogenic bacteria,including Klebsiella pneumoniae pneumoniae,and Escherichia coli.Semi synthetic penicillin with third generation cephalosporins and nitro imidazole were the standard treatment procedure.Sometimes,the treatment procedure was adjusted,according to the clinical,manifestation inflammatory markers and antimicrobial susceptibility test results.