Neonatal gastric perforation: a systematic review and meta-analysis of clinical characteristics, risk factors, surgical management and outcomes.
完整摘要 · 中文译文
背景：新生儿胃穿孔（NGP）是一种罕见但危及生命的新生儿外科急症。我们系统综述了其临床特征、危险因素、外科管理和结局。 方法：检索5个数据库自建库至2025年12月31日的观察性研究，纳入报告至少5例确诊胃穿孔新生儿（≤ 28天）的研究。两名评审员独立筛选记录、提取数据并评价质量。采用随机效应模型合并比例；死亡预测因素以比值比（OR）汇总。本综述遵循PRISMA 2020，并在国际前瞻性系统评价注册平台（PROSPERO）注册。 结果：共纳入20项研究（410例新生儿）。合并患病率为早产58.3%、低出生体重63.5%、男性59.0%；腹胀（90.5%）和气腹（80.9%）是最常见的特征。78.4%的接受手术新生儿实施了原发修补。合并院内死亡率为28.6%（95% CI 22.0-36.3%）。就诊时脓毒症（OR 4.10）和手术延迟超过24小时（OR 3.55）是最强的死亡预测因素。 结论：NGP主要影响早产、低出生体重新生儿，目前仍伴有约28%的死亡率。早期识别、及时治疗脓毒症和适时手术是改善生存的最明确途径。 PROSPERO注册号：CRD420261436438。
完整摘要 · 英文原文
BACKGROUND: Neonatal gastric perforation (NGP) is a rare but life-threatening surgical emergency of the newborn. We systematically reviewed its clinical characteristics, risk factors, surgical management and outcomes. METHODS: Five databases were searched from inception to 31 December 2025 for observational studies reporting at least five neonates (≤ 28 days) with confirmed gastric perforation. Two reviewers independently screened records, extracted data and appraised quality. Proportions were pooled using random-effects models; predictors of mortality were summarised as odds ratios (OR). The review followed PRISMA 2020 and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). RESULTS: Twenty studies (410 neonates) were included. Pooled prevalences were prematurity 58.3%, low birth weight 63.5% and male sex 59.0%; abdominal distension (90.5%) and pneumoperitoneum (80.9%) were the commonest features. Primary repair was performed in 78.4% of operated neonates. Pooled in-hospital mortality was 28.6% (95% CI 22.0-36.3%). Sepsis at presentation (OR 4.10) and delay to surgery beyond 24 h (OR 3.55) were the strongest predictors of death. CONCLUSIONS: NGP mainly affects premature, low-birth-weight neonates, and still carries approximately 28% mortality. Early recognition, prompt treatment of sepsis and timely surgery offer the clearest route to improved survival. PROSPERO ID: CRD420261436438.
摘要 待译
BACKGROUND: Neonatal gastric perforation (NGP) is a rare but life-threatening surgical emergency of the newborn. We systematically reviewed its clinical characteristics, risk factors, surgical management and outcomes. METHODS: Five databases were searched from inception to 31 December 2025 for observational studies reporting at least five neonates (≤ 28 days) with confirmed gastric perforation. Two reviewers independently screened records, extracted data and appraised quality. Proportions were pooled using random-effects models; predictors of mortality were summarised as odds ratios (OR).…