新生儿坏死性小肠结肠炎发生的危险因素研究  

Study on risk factors of neonatal necrotizing enterocolitis

作　　者：杨雪峰[1] 安建峰[1] Yang Xuefeng;An Jiangfeng(Xi'an Children's Hospital(Xi'an 710003))

机构地区：[1]西安市儿童医院,西安710003

出　　处：《陕西医学杂志》2018年第10期1249-1251,共3页Shaanxi Medical Journal

基　　金：陕西省自然科学基金资助项目(2005C2-66)

摘　　要：目的:研究新生儿坏死性小肠结肠炎(NEC)发生的危险因素。方法 :采用回顾性分析法,收集NEC治疗的新生儿临床资料358例,并随机抽取同期在我院住院治疗的非NEC患儿342例,NEC组设为观察组,非NEC组设为对照组。收集患儿的围产期资料及合并疾病进行单因素分析,围产期资料包括分娩方式、早产、母妊娠高血压、母妊娠期糖尿病、母孕期使用地塞米松、胎盘早破、呼吸窘迫综合征、低体重儿、羊水异常、出生窒息、喂养方式。合并疾病包括先天性心脏病、感染肺炎、呼吸窘迫综合征、肺出血、消化道出血、低血糖症、电解质紊乱、败血症、高胆红素血症、胆汁淤积症。随后选取可能会对NEC产生影响的因素进行多因素Logistics分析。结果 :观察组患儿病死率(15.08%)明显高于对照组患儿(3.21%)(P<0.05)。低体重儿、出生窒息、母乳喂养和早产儿中对照组和观察组差异有统计学意义(P<0.05);剖宫产、母妊娠高血压、母妊娠糖尿病、母孕期使用地塞米松、羊水异常和胎膜早破两组之间差异没有统计学意义(P>0.05)。两组患儿中败血症和高胆红素血症的发生率有差异有统计学意义(P<0.05);先天性心脏病、感染性肺病、呼吸窘迫综合征、低血糖、肺出血、电解质紊乱、消化道出血和胆汁淤积症发生率两组患者均差异没有统计学意义(P>0.05)。将进行单因素分析后显示有统计学差异的变量纳入NEC发生的多因素Logistics分析显示,低体重儿、出生窒息、早产儿、败血症、高胆红素血症为NEC发病的主要危险因素,母乳喂养为NEC发病的保护性因素。结论:低体重儿、出生窒息、早产儿、败血症和喂养方式均为NEC发生的独立危险因素,高胆红素症对NEC发生的影响还需进一步研究。Objective:Purpose The risk factors for neonatal necrotizing enterocolitis were studied in this paper.Methods:A retrospective analysis was used to collect data on 358 neonates undergoing NEC treatment,we randomly selected 342 non-NEC patients hospitalized in our hospital during the same period.The NEC group was used as the observation group,and the non-NEC group was set as the control group.Perinatal data and comorbidities were collected for univariate analysis.Perinatal data included delivery,premature delivery,maternal gestational hypertension,maternal gestational diabetes,dexamethasone during pregnancy,premature rupture of placenta,respiratory distress syndrome,low birth weight,abnormal amniotic fluid,birth asphyxia,feeding methods.Subsequently,multivariate Logistics analysis was performed to select factors that may affect NEC.Results:The mortality rate in the observation group(15.08%)was significantly higher than that in the control group(3.21%)(P<0.05).There was a significant difference between the control group and the observation group in low birth weight,birth asphyxia,breastfeeding and preterm infants(P<0.05).There was no significant difference between cesarean section,maternal gestational hypertension,maternal gestational diabetes,dexamethasone during pregnancy,amniotic fluid abnormalities and premature rupture of membranes(P>0.05).There was a significant difference in the incidence of sepsis and hyperbilirubinemia between the two groups(P<0.05).There was no significant difference in the incidence of congenital heart disease,infectious lung disease,respiratory distress syndrome,hypoglycemia,pulmonary hemorrhage,electrolyte imbalance,gastrointestinal hemorrhage and cholecytosis(P>0.05).Multivariate logistics analysis showed that low birth weight infants,birth asphyxia,premature infants,sepsis,and hyperbilirubinemia were the main risk factors for the development of NEC,feeding is a protective factor for the onset of NEC.Conclusion:Low birth weight infants,birth asphyxia,premature infants,sepsis and feeding

关 键 词：小肠结肠炎 @新生儿 危险因素 

分 类 号：R722.1[医药卫生—儿科]