目的　分析新生儿坏死性小肠结肠炎（NEC）与自发性肠穿孔（SIP）的临床特征。方法　回顾分析1996年5 月至2016年8月收治的NEC发生肠道穿孔以及同期收治的SIP患儿临床资料，比较两组患儿围生期相关指标，主要合并 症或并发症，治疗结局等。结果　共纳入101例肠穿孔患儿，NEC组70例、SIP组31例。两组患儿的性别比、生产方式、胎 龄、出生体质量、窒息、宫内窘迫、早产和低体质量比例，以及发病日龄、住院天数方面的差异均无统计学意义（P>0.05）。 NEC组患儿病死率高于SIP组，合并或并发低蛋白血症以及败血症的比例均高于SIP组，差异均有统计学意义（P<0.05）。 NEC组最常见穿孔部位为大肠，其次为小肠；SIP组最常见穿孔部位为小肠，其次为大肠；NEC组与SIP组患儿穿孔部位 及穿孔数量比较，差异均无统计学意义（P>0.05）。 结论　与SIP患儿相比，NEC患儿更容易罹患败血症及低蛋白血症，病 死率也更高。

Objective　To analyze the clinical features of neonatal necrotizing enterocolitis (NEC) by comparison to spontaneous intestinal perforation (SIP). Methods　Medical records of infants with surgical NEC or SIP in the Children's Hospital of Chongqing Medical University between May 1996 and Aug. 2016 were retrospectively reviewed. The perinatal demography, comorbidities, complications and outcomes between the two groups were compared. Results　A total of 70 infants with surgical NEC and 31 infants with SIP were enrolled in the study, and the gestational age, birth weight and onset age were similar in both groups (P>0.05). Higher incidence of sepsis (47.1% vs. 12.9%, χ2=10.851, P=0.001) and hypoproteinemia (67.1% vs. 35.5%, χ2=8.808, P=0.003) were found in infants with NEC than those with SIP. The mortality was higher in infants with NEC than those with SIP (35.7% vs. 16.1%, χ2=3.947, P=0.047). Conclusions　Compared to infants with SIP, neonates with surgical NEC were associated with higher mortality due to higher incidence of sepsis and hypoproteinemia.