影响早产儿坏死性小肠结肠炎预后的危险因素分析  

Analysis of Risk Factors Related to the Prognosis of Necrotizing Enterocolitis Among Premature Infants.

作　　者：马兴娜[1,2] 孔祥永[1] 王瑞娟[1] 黄捷婷[1] 黄俊谨[1] 封志纯[1] 

机构地区：[1]北京军区总医院附属八一儿童医院新生儿重症监护中心,北京100007 [2]山西医科大学

出　　处：《实用预防医学》2013年第4期388-391,共4页Practical Preventive Medicine

基　　金：国家自然科学基金项目(81170603)

摘　　要：目的探讨影响早产儿坏死性小肠结肠炎(NEC)预后的相关危险因素,为临床决策提供参考经验。方法 2008年1月-2012年10月收住的53例胎龄<32周、Bell分期Ⅱ期以上的早产儿坏死性小肠结肠炎的临床资料,根据其预后不同分为治愈组(36例)和预后不良组(17例),对两组患儿的临床资料进行回顾性分析、对比研究。结果单因素分析发现,重度窒息、发病前3 d内输血、动脉导管未闭、感染性肺炎、血小板计数下降、凝血酶原时间延长6个因素与NEC预后不良有关(P均<0.05);多因素Logistic回归分析发现重度窒息、发病前3 d内输血及血小板计数下降是NEC预后不良的独立危险因素(P均<0.05)。结论重度窒息、发病前3 d内输血及血小板计数下降是导致NEC早产儿预后不良的主要危险因素,应高度重视这些因素,积极治疗,以改善预后。Objective To explore the risk factors related to the prognc,sis of necrotizing enterocolitis （NEC） among premature infants, so as to provide reference for making clinical decisions. Methods Totally, 53 preterm infants （with gestational age≤32w and Bell stage Ⅱ or Ⅲ ）, who were admitted to Bayi Children＇ s Hospital Affiliated to Beiiing Military Area Commands General Hospital from January 2008 to October 2012 were enrolled. Based on their prognosis, 36 infants were assigned into the recovery group and 17 infants into the poor outcome group. Retrcxspective analysis was conducted on their clinical data. Results Single factor analysis showed that severe asphyxia, transfusion of red blc^t cells three days before NEC occurring, patent ductus arterious （PDA）, pneumonia, decreased PLT count and prolonged prothrombin time （PT） were significantly corre- lated with the poor outcome of NEC（P 〈 0.05）. Further analysis by Logistic regression indicated that severe asphyxia, transfusion of red blood cells three days before NEC occurring and decreased PLT count were independent predictors. Conclusions Severe asphyxia, transfusion of red blood cells three days before NEC occurring and decreased PLT count are high risk factors affecting the prognosis of NEC among premature infants. Great attention should be paid to these factors to improve the outcome of NEC.

关 键 词：早产儿 坏死性小肠结肠炎 预后 危险因素 

分 类 号：R725.7[医药卫生—儿科]