新生儿坏死性小肠结肠炎237例危险因素分析  

Analysis of risk factors for 237 cases of neonatal necrotizing enterocolitis

作　　者：尚利宏[1] 赵艳梅[1] 雷冰 粟文娟 王金光 Shang Lihong, Zhao Yanmei, Lei Bing, Li Wenjuan, Wang Jinguang(Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第三附属医院新生儿科,450052

出　　处：《中国实用医刊》2018年第4期57-60,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨新生儿坏死性小肠结肠炎（NEC）的临床发病特点及预后危险因素。方法回顾性分析237例NEC患儿的临床资料，按是否手术分为手术组、非手术组，按胎龄分为早产儿组、足月儿组，分别对两组预后危险因素进行对比分析。结果①与非手术组比较，手术组患儿胎龄小、出生体质量低、白细胞计数及C-反应蛋白明显升高、血小板明显降低、病死率高，差异均有统计学意义（P〈0.05）。②影响足月儿NEC结局的危险因素有新生儿肺炎、先天性巨结肠，早产儿与胎龄、感染、低出生体质量、RDS级数、喂养、发病前应用抗生素、先天性心脏病、代谢性酸中毒、凝血功能异常、中心静脉置管等，差异均有统计学意义（P〈0.05）。进一步Logistic分析，影响早产儿结局的独立危险因素有胎龄（OR＝5.59，95%CI＝1.995～15.672）、败血症（OR＝5.17，95%CI＝1.907～14.027），足月儿有新生儿肺炎（OR＝24.78，95%CI＝2.100～260.540）、先天性巨结肠（OR＝7.62, 95%CI＝1.400～41.45），P均〈0.05。结论早产儿与足月儿危险因素不同，早产儿危险因素与胎龄、感染等相关，足月儿与感染、先天性巨结肠等有关，胎龄小、出生体质量低的NEC患儿预后差。ObjectiveTo analyze the characteristics and risk factors of neonatal necrotizing enterocolitis.MethodsThe clinical data were retrospectively analyzed in 237 neonatal suffering from NEC. According to the operation, the patients were divided into the operation group and the non operation group and the patients were divided into the premature infant group and the full-term infants group according to the gestational age. The risk factors of prognosis were compared and analyzed.Results①Compared with the non operation group, the operation group had smaller gestational age, lower birth weight, higher infection indexes （white blood cell count, C-reactive protein and the platelet count）and the mortality, the differences were significant（P〈0.05）. ②Single factor analysis showed that the main risk factors of full-term were infection, congenital megacolon, premature infants with low birth weight, infection, RDS series, feed, antibiotic exposure, congenital heart disease, metabolic acidosis, central venous catheterization, abnormal coagulation function. Further Logistic analysis, the risk factors of premature infants were gestational age （OR=5.59, 95%CI=1.995-15.672）, sepsis （OR=5.17, 95%CI=1.907-14.027）. The risk factors of full-term infants were pneumonia （OR=24.78, 95%CI=2.100-260.540）, congenital megacolon（OR=7.62, 95%CI=1.400-41.450）, the differences were significant （P〈0.05）.ConclusionsThe risk factors of premature infants and full-term infants are not the same. Premature infants are correlated with gestational age and infection. Full-term infants are correlated with to infection and Hirschsprung’s disease. The prognosis of NEC children with low birth weight and low birth age is poor.

关 键 词：新生儿 坏死性小肠结肠炎 感染 早产儿 

分 类 号：R722.1[医药卫生—儿科]