34例新生儿坏死性小肠结肠炎手术早产儿的临床特征分析  

Analysis on the clinical characteristics of 34 premature infants with neonatal necrotizing enterocolitis undergoing surgery

作　　者：杨艳[1] 俞生林[1] 黄顺根[1] YANG Yan;YU Sheng-Lin;HUANG Shun-Gen(Children's Hospital Affiliated to Suzhou University,Suzhou,Jiangsu 215025,China)

机构地区：[1]苏州大学附属儿童医院,江苏苏州215025

出　　处：《中国妇幼保健》2020年第22期4252-4255,共4页Maternal and Child Health Care of China

基　　金：江苏省妇幼健康科研项目(F201710);苏州市临床重点病种诊疗技术专项(LCZX201709)。

摘　　要：目的探讨发生新生儿坏死性小肠结肠炎(NEC)并手术治疗的早产儿的临床特征。方法选取2014年9月1日-2019年7月31日34例NEC手术早产儿病例,按照发病时间不同分为早发型(<14 d,18例)及晚发型(≥14 d,16例),对其临床资料进行回顾性分析。结果34例早产儿中,平均发病日龄(16.7±13.1)d,早发型组平均胎龄大于晚发型组(32.3±2.6 vs.29.6±1.2周)、出生体质量大于晚发型组(1746.7±646.5 vs.1316.9±216.0g),差异有统计学意义(P<0.05)。早发型组围生期缺氧、新生儿呼吸窘迫综合征(NRDS)发生率高于晚发型组;晚发型组发病前一周贫血、输血率高于早发型组(P<0.05)。发病症状中,腹胀29例(85.3%)、呕吐10例(29.4%)、腹泻1例(2.9%)、血便11例(32.4%)、呼吸暂停13例(38.2%)、发热或体温不升9例(26.5%)及皮肤花纹11例(32.4%)。早发型组多以发热或体温不升、呼吸暂停为起病症状,晚发型组多以腹胀为起病症状(P<0.05)。术后宫外生长发育迟缓(EUGR)的发生率为91.2%。两组术后并发症和预后无明显差异(P>0.05)。结论早发型和晚发型NEC手术早产儿各有其临床特征,应加强早期识别并防治围手术期的高危疾病,以改善患儿预后。Objective To explore the clinical characteristics of premature infants with neonatal necrotizing enterocolitis(NEC)undergoing surgery.Methods From September 1st,2014 to July 31st,2019,34 NEC premature infants undergoing surgery were selected and divided into early-onset group(<14 days,18 infants)and late-onset group(≥14 days,16 infants),the clinical data were analyzed retrospectively.Results The mean age of onset was(16.7±13.1)days,the mean gestational age of onset in early-onset group was(32.3±2.6)weeks,which was statistically significantly higher than that in late-onset group[(29.6±1.2)weeks];the birth weight in early-onset group was(1746.7±646.5)g,which was statistically significantly higher than that in late-onset group[(1316.9±216.0)g](P<0.05).The incidence rates of perinatal hypoxia and neonatal respiratory distress syndrome(NRDS)in early-onset group were statistically significantly higher than those in late-onset group,the rates of anemia and blood transfusion during one week before onset in late-onset group were statistically significantly higher than those in early-onset group(P<0.05).The incidence rates of abdominal distension,vomiting,diarrhea,bloody stools,apnea,fever or low temperature,and skin stripe were 85.3%(29 infants),29.4%(10 infants),2.9%(1 infant),32.4%(11 infants),38.2%(13 infants),26.5%(9 infants),and 32.4%(11 infants),respectively.In early-onset group,fever or low temperature,apnea were the onset symptoms;in late-onset group,abdominal distension was the onset symptoms(P<0.05).The incidence rate of extrauterine growth restriction(EUGR)after surgery was 91.2%.There was no statistically significant difference in the incidence rate of complications and prognosis between the two groups(P>0.05).Conclusion Early-onset and late-onset NEC premature infants undergoing surgery have their own clinical characteristics,high-risk diseases during perioperative period should be diagnosed,prevented,and treated early to improve prognosis.

关 键 词：新生儿坏死性小肠结肠炎 早产儿 手术 

分 类 号：R722.1[医药卫生—儿科]