【摘要】 目的 深入了解新生儿消化道穿孔X线表现，并对发病部位与发病原因及预后评估进行探讨。方法 对照分析24例临床手术资料与X线征象。结果 各种位置X线检查发现气腹23例，大量气腹7例，中量气腹11例，少量气腹5例。气腹的X线表现除常见的膈下游离气体外，在卧位或水平侧位X线照片中还可见足球征13例，镰状韧带征12例，铅笔征或Rigler征10例，“黑三角”征3例。气腹以外的其他征象：胃泡影消失6例，肠管少气11例，肠管充气增多12例，肠管无气1例，肠间隙增宽12例，肠壁积气5例，腹腔液体增多15例，外围肠管可见气粪混合征3例。消化道穿孔原因：胃壁先天性肌层缺损5例，各种先天性小肠畸形6例，结肠和直肠畸形4例，坏死性小肠结肠炎7例，胎粪性腹膜炎1例。结论 X线检查仍然是发现新生儿消化道穿孔的首选方法，对穿孔的原因和预后评估有一定帮助。

    【关键词】 新生儿；消化道；穿孔；X线摄影术

    Perforation of alimentary tract in neonate:radiologic findings,causes and prediction of prognosis

    ZHAI Jian-kun.

    Department of Radiology,Taiping People’s Hospital,Dongguan 523900,China

    【Abstract】 Objective To know about the radiologic findings of perforation of alimentary tract in different projections,and to discuss the etiology of disease and prediction of prognosis.Methods Clinical records and radiologic findings of 24 cases were analyzed retrospectively.Results 23 pneumoperitoneum were detected by radiologic examinations in different projections.The common radiologic findings of pneumoperitoneum included free air below diaphragm,football sign(13 cases),falciform sign(12 cases),Rigler sign(10 cases)in AP supine and black triangle sign in lateral beam projection(3 cases).Other signs included disappearance of gastric bulb(6 cases),less gas of intestine(11 cases),increasing gas of intestine(12 cases),gasless of intestine(1 case),separation of bowl loops(12 cases),pneumatosis intesinal(5 cases),ascites(15 cases),air-stool mixing in colon(3 cases).Causes of perforation of alimentary tract:Defects of gastric musculature(5 cases),congenital malformations of small intestine(6 cases),malformations of colons and rectums(4 cases),necrotizing enterocolitis(7 cases)and meconium peritonitis(1 case).Conclusion It is an important method and first choice to detect perforation with radiologic examination,and it could also help to presume causes and predict prognosis. ......