新生儿坏死性小肠结肠炎的腹片评分研究  

The Study of Radiographic Duke Abdominal Assessment Scale in Neonatal Necrotizing Enterocolitis

作　　者：邓博引[1] 何华云[1] 余国容[2] 王佚[3] 华子瑜[1] 

机构地区：[1]重庆医科大学附属儿童医院新生儿科,400014 [2]重庆医科大学附属儿童医院放射科,400014 [3]重庆医科大学附属儿童医院普外科,400014

出　　处：《临床放射学杂志》2014年第6期912-915,共4页Journal of Clinical Radiology

摘　　要：目的探讨腹部X线量表评分在新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)中的应用。方法 2012年在我院新生儿科住院的日龄<28天的足月儿或者纠正胎龄<42周的早产儿中,222例疑诊或确诊NEC,搜集其临床资料进行回顾性研究,腹部X线量表进行腹片评分。结果 BellⅠ期、Ⅱ期、Ⅲ期患儿腹片评分分别为(3.72±1.634)分,(5.49±1.882)分和(8.84±2.375)分,各期评分差异均具有统计学意义(P=0.000);治愈率分别为66.7%(78/117),53.9%(41/76)和20.0%(5/25),Ⅰ期与Ⅱ期治愈率较Ⅲ期差异有统计学意义(P<0.05)。Logistic回归提示,Bell分期(χ1)、败血症(χ2)与NEC预后密切相关:y=0.804χ1+1.002χ2-2.940。结论腹部X线量表评分随NEC病情加重而升高,一定程度上量化腹片异常的严重程度,更好地指导临床诊疗。Objective To study the value of radiographic Duke Abdominal Assessment Scale in neonatal necrotizing enterocolits （NEC）. Methods Total 222 neonates with suspected or confirmed NEC, hospitalized in our hospital during 2012, were enrolled. The clinical data and plain abdominal radiography images were collected and retrospectively analyzed. Plain abdominal radiography images were graded with Radiographic Duke Abdominal Assessment Scale. Results Radiographic Duke Abdominal Assessment Scores of Bell stage Ⅰ , stage Ⅱ and stage Ⅲ were 3.72 ± 1. 634, 5.49 ± 1. 882, 8.84 ± 2.375, respectively. There was significant difference of scores among Bell stages （ P = 0.000 ）. The curative ratio of Bell stage Ⅰ , Ⅱ, and Ⅲ was 66.7% （78/117）, 53.9% （41/76） and 20.0% （5/25） respectively. There was signifi- cant difference of curative ratio between Bell stage Ⅰ and Ⅲ, as well as stagelI and Ⅲ （P 〈 0. 05 ）. Logistic regression about prognosis indicated y = 0. 804x1 ＋ 1. 002x2 - 2. 940 （ Bell＇s stage ： x1, Sepsis ： x2 ） . Conclusion The study show the higher Bell＇s stage, the severer abdominal assessment scores. Radiographic Duke Abdominal Assessment Scale does quantify the severity of abnormality in NEC.

关 键 词：新生儿 坏死性小肠结肠炎 Bell分期 腹部X线量表预后 

分 类 号：R722.1[医药卫生—儿科]