新生儿坏死性小肠结肠炎临床特点及发病影响因素  

Clinical characteristics of neonates with necrotizing enterocolitis (NEC) and its influence factors

作　　者：张丽蓉 林艾[1] 赵智勇[1] 张家友 ZHANG Lirong;LIN Ai;ZHAO Zhiyong;ZHANG Xueyou(Guangyuan Central Hospital,Guangyuan,Sichuan Province,628000;The Second Hospital Affiliated to Chengdu Medical College,Nuclear Industry 416 Hospital,Chengdu,Sichuan Province)

机构地区：[1]四川省广元市中心医院,628000 [2]成都医学院附属第二医院,核工业四一六医院

出　　处：《中国计划生育学杂志》2024年第7期1692-1697,共6页Chinese Journal of Family Planning

基　　金：2021年四川省医学(青年创新)科研课题(S21060)。

摘　　要：目的:探讨不同胎龄新生儿坏死性小肠结肠炎(NEC)的临床特点及发病影响因素。方法:选取2019年9月-2023年10月本院出生并接受治疗的368例NEC新生儿为研究对象,本院出生的正常健康新生儿736例为对照组。根据胎龄将新生儿分为早产儿(胎龄<37周)和足月儿(胎龄≥37周),记录基本情况、临床表现以及主要合并症等,分析影响新生儿NEC发病的影响因素。结果:368例NEC患儿中早产儿295例(80.2%)、足月儿73例(19.8%)。两组NEC患儿临床主要表现为腹胀、便血、呕吐和肠鸣音减弱,且NEC患儿中足月儿组腹胀、肠鸣音减弱、肌张力减弱、肠穿孔、腹壁静脉显露的临床表现少于早产儿组,便血、呕吐高于早产儿组(均P<0.05)。多因素logistic回归分析表明,妊娠期肝内胆汁淤积和输注富含红细胞是早产儿NEC发病危险因素,母乳喂养是早产儿NEC发病保护因素;妊娠期糖尿病、新生儿感染和羊水污染是足月儿NEC发病独立危险因素;新生儿窒息、呼吸衰竭、脓毒症、先天性心脏病为新生儿NEC发病独立危险因素,预防性应用益生菌为NEC发病保护因素(均P<0.05)。结论:NEC多发于早产儿,以腹胀、便血、呕吐和肠鸣音减弱为主要临床表现,不同胎龄新生儿NEC发病因素不同,预防性应用益生菌可降低新生儿NEC风险,而母乳喂养有利于避免早产儿NEC发生。Objective:To explore the clinical characteristics of the necrotizing enterocolitis(NEC) of neonates with different gestational weeks,and to study its influencing factors of NEC occurrence.Methods:368 neonates with NEC who were born and treated in the hospital between September 2019 and October 2023 were selected in study group,and736 healthy neonates who born in the hospital during the same period were selected in control group.According to the gestational age of the newborns in the study group,the neonates were divided into group A(premature infants with <37 gestational weeks) and group B(full-term infants with ≥37 gestational weeks).The basic information,the clinical manifestations,and the major complications of the neonates in these groups were recorded.The influencing factors of NEC occurrence of the neonates were analyzed.Results:In the study group,there were 295(80.2%) premature infants and 73(19.8%) full-term infants.The main clinical manifestations of the neonates with NEC were the abdominal distension,the hematochezia,the vomiting and the weakened bowel sounds.The rates of the clinical manifestations,such as the abdominal distension,the weakened bowel sounds,the weakened muscle tension,the intestinal perforation and the abdominal wall vein exposure of the neonates in group B were significantly less than those of the neonates in group A.The rates of the hematochezia and the vomiting of the neonates in group B were significantly higher than those of the neonates in group A(all P<0.05).Multivariate logistic regression analysis showed that the intrahepatic cholestasis of pregnancy and the transfusion of rich red blood cells of the women were the risk factors of the NEC occurrence of their preterm infants,and the breast feeding was a protective factor of the NEC occurrence of their preterm infants.The gestational diabetes mellitus,the neonatal infection and the amniotic fluid contamination of the women were the independent risk factors of the NEC occurrence of their full-term infants.The neonatal asphyxia,t

关 键 词：新生儿 坏死性小肠结肠炎 临床特点 影响因素 

分 类 号：R722.1[医药卫生—儿科]