Dilli Dilek, Eras Zeynep, Özkan Ulu Hülya, Dilmen Uğur, Durgut Şakrucu Evrim
Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey.
Pediatr Surg Int. 2012 May;28(5):471-6. doi: 10.1007/s00383-012-3051-4. Epub 2012 Jan 25.
To evaluate the effect of necrotizing enterocolitis (NEC) on growth and neurodevelopmental outcome.
Neurodevelopmental outcome of 20 of 39 surviving very low birthweight infants (VLBW) diagnosed with NEC between 2007 and 2009 was compared with 40 control infants matched for gestational age and year of admission. Follow-up studies were performed at 18 and 24 months of corrected age. Bayley Scales of Infant Development-Second Edition scale was used for neurodevelopmental assessment.
At 18-24 months corrected age, body weight, body length, and head circumference did not differ significantly between the NEC and without NEC groups. The median mental developmental index (62 vs. 75, p = 0.008) and psychomotor developmental index points (72 vs. 91.5, p = 0.002) were lower in infants with NEC compared to without NEC, respectively. Although the rate of neurodevelopmental impairment was slightly higher in infants with NEC, there were no differences between the groups according to the frequency of minimal impairment and cerebral palsy. Growth or neurodevelopmental outcome did not differ between the NEC survivors with and without surgery.
Necrotizing enterocolitis has affected neurodevelopmental outcome but not growth in VLBW infants at 18-24 months of corrected age. Both those treated medically or requiring surgery need close neurodevelopmental follow-up for the first years of life.
评估坏死性小肠结肠炎（NEC）对生长及神经发育结局的影响。
将2007年至2009年间确诊为NEC的39例存活的极低出生体重儿（VLBW）中的20例的神经发育结局，与40例匹配了胎龄和入院年份的对照婴儿进行比较。在矫正年龄18个月和24个月时进行随访研究。使用贝利婴儿发育量表第二版进行神经发育评估。
在矫正年龄18 - 24个月时，NEC组和无NEC组之间的体重、身长和头围无显著差异。与无NEC的婴儿相比，NEC婴儿的平均智力发育指数（分别为62对75，p = 0.008）和精神运动发育指数得分（分别为72对91.5，p = 0.002）较低。虽然NEC婴儿的神经发育障碍发生率略高，但根据轻度损伤和脑瘫的发生率，两组之间没有差异。接受手术和未接受手术的NEC存活者的生长或神经发育结局没有差异。
坏死性小肠结肠炎在矫正年龄18 - 24个月时影响VLBW婴儿的神经发育结局，但不影响生长。无论是接受药物治疗还是需要手术治疗的婴儿，在生命的头几年都需要密切的神经发育随访。
