Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Analysis of Neonatal Gastrointestinal Diseases in a Neonatal Intensive Care Unit for 3 Years Neonatal GI Diseases in a NICU for 3 Years

3년간 단일기관 신생아실의 위장관 질환의 분석

  • Kwon, Kyoung-Ah (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Bae, Mi-Hae (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Park, Kyung-Hee (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Byun, Shin-Yun (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Cho, Yong-Hoon (Department of Surgery, Pusan National University School of Medicine) ;
  • Kim, Hae-Young (Department of Surgery, Pusan National University School of Medicine) ;
  • Sung, Si-Chan (Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine)
  • 권경아 (부산대학교 의학전문대학원 소아과학교실) ;
  • 배미혜 (부산대학교 의학전문대학원 소아과학교실) ;
  • 박경희 (부산대학교 의학전문대학원 소아과학교실) ;
  • 변신연 (부산대학교 의학전문대학원 소아과학교실) ;
  • 조용훈 (부산대학교 의학전문대학원 외과학교실) ;
  • 김해영 (부산대학교 의학전문대학원 외과학교실) ;
  • 성시찬 (부산대학교 의학전문대학원 흉부외과학교실)
  • Published : 2011.11.30
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Abstract

Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.

목적: 신생아 시기에 수술적 치료를 한 위장관계 질환과 저체중 출생아에서 발생 빈도가 높은 위장관계 질환에 대한 이해를 높이고자 한다. 방법: 2008년 1월부터 2010년 12월까지 부산대학교병원과 부산대학교 어린이병원 신생아실에 입원한 환아 중 위장관계 질환으로 진단되고 외과적 치료를 받은 125명과 괴사성 장염과 서혜부 탈장으로 진단받은 환아 40명을 대상으로 원인 질환 및 빈도, 출생력, 성별, 동반 기형과 혈청학적 결과를 살펴보았다. 결과: 괴사성 장염과 서혜부 탈장을 제외한 총 125명 환아 중에서 항문 직장 기형이 가장 흔하였고, 남성이 우세하였다. 24명(19.2%)에서 타기형이 동반되었고 수신증, 선천성 심장 기형이 많았으며, 항문 직장 기형에서는 43.9%에서 동반 기형이 있었다. 출생체중을 보면 괴사성 장염의 경우 76.0%가 1,500 g 미만으로 대부분을 차지하였다. 술 후 완전 장관 영양까지의 기간은 괴사성 장염이 평균 30.8일로 가장 길었다. 술 후 합병증은 담즙정체증, 패혈증과 유착 등이 있었다. 괴사성 장염을 제외한 위장관계 질환으로 수술적 치료를 받았던 환자들은 1.6%의 사망률을 보였으며 수술적 치료를 받은 괴사성 장염의 사망률은 18.8%였다. 괴사성 장염의 수술군에서 보존적 치료군보다 직접 빌리루빈이 의미있게 더 높았다. 결론: 수술적 치료를 받은 위장관 질환의 생존율은 높고 수술적 치료의 성과도 우수하였다. 괴사성 장염 환아 중 수술군에서 직접 빌리루빈이 유의하게 더 높았다.

Keywords

References

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