新生儿输血相关性坏死性小肠结肠炎的影响因素分析  

Analysis of influence factors of transfusion-associated neonatal necrotizing enterocolitis

作　　者：曾慧仪 郭娟娟 刘丹丹[2] 蔡纯 娄蕾 鲍俏[3] 冯周善 张刚 ZENG Huiyi;GUO Juanjuan;LIU Dandan;CAI Chun;LOU Lei;BAO Qiao;FENG Zhoushan;ZHANG Gang(Department of General Surgery,Huizhou Second Maternal and Child Health Hospital,Huizhou 516000,China;Guangdong Provincial Key Laboratory of Major Obstetric Diseases,Guangdong Provincial Clinical Research Center for 0bstetrics and Gynecology,Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China;Department of Pediatric Surgery,Guangdong Women and Children’s Hospital,Guangzhou 510010,China)

机构地区：[1]惠州市第二妇幼保健院综合外科,广东惠州516000 [2]广东省产科重大疾病重点实验室,广东省妇产疾病临床医学研究中心,粤港澳母胎医学高校联合实验室,广州医科大学附属第三医院,广东广州510150 [3]广东省妇幼保健院小儿外科,广东广州510010

出　　处：《新医学》2024年第7期565-570,共6页Journal of New Medicine

基　　金：广东省中医药局科研课题(20221044);广州市科技计划项目(202201020395)。

摘　　要：目的探讨新生儿输血相关性坏死性小肠结肠炎(TANEC)发病的相关影响因素。方法回顾性分析已接受手术治疗的坏死性小肠结肠炎(NEC)患儿的临床资料,将其分为TANEC组与非TANEC组,对2组的临床特征、母亲情况、实验室检查结果、术中情况及预后结果进行单因素及多因素Logistic回归分析,明确TANEC发生的相关因素,并采用受试者操作特征(ROC)曲线与曲线下面积(AUC)评估这些因素对TANEC的预测价值。结果共纳入51例患儿,其中TANEC组13例、非TANEC组38例。单因素分析显示2组NEC患儿的出生体质量、阿普加评分、胎龄、输血次数、合并动脉导管未闭、血红蛋白水平比较差异均有统计学意义(P均<0.05)。多因素Logistic回归分析显示输血次数、血红蛋白水平是发生TANEC的影响因素(P均<0.05)。ROC曲线验证输血次数的AUC为0.882(95%CI 0.794~0.969),血红蛋白水平的AUC为0.857(95%CI 0.747~0.968),两者联合的AUC为0.907(95%CI 0.822~0.992)。结论输血次数、血红蛋白水平与TANEC的发生相关,两者联合可较好地预测TANEC的发生。Objective To investigate the related influence factors of neonatal transfusion-associated necrotizing enterocolitis(TANEC).Methods Clinical data of neonates with necrotizing enterocolitis(NEC)treated by surgery were retrospectively analyzed.All participants were divided into the TANEC and non-TANEC groups.Clinical characteristics,maternal conditions,laboratory test results,intraoperative conditions and clinical prognosis were subject to univariate and multivariate Logistic regression analyses.Related factors of TANEC were identified.The predictive values of these factors were determined by the receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC).Results A total of 51 infants were enrolled in this study,including 13 cases in the TANEC group and 38 in the non-TANEC group.Univariate analysis showed statistically significant differences in birth weight,Apgar-1 score,gestational age,number of transfusions,patent ductus arteriosus and hemoglobin level between two groups(all P<0.05).Multivariate Logistic regression analysis revealed that the number of transfusions and hemoglobin level were the related factors for the incidence of TANEC(both P<0.05).ROC curve verified that the AUC of the number of transfusions was 0.882(95%CI 0.794-0.969),0.857(95%CI 0.747-0.968)for hemoglobin level,and 0.907(95%CI 0.822-0.992)for the two combined,respectively.Conclusion The number of blood transfusion and hemoglobin level are associated with the occurrence of TANEC,and the combination of these two can better predict the incidence of TANEC.

关 键 词：新生儿 输血相关性坏死性小肠结肠炎 输血次数 血红蛋白 

分 类 号：R722.1[医药卫生—儿科]