Lin Hui-Jia, Shi Li-Ping, Luo Fang, Bao Yu, Ma Xiao-Lu
Department of Neonatal Intensive Care Unit, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2012 Feb;14(2):97-100.
This study was conducted to determine the value of the radiographic assessment scale in the diagnosis of neonatal necrotizing enterocolitis, and as measured by need for surgery.
A total of 61 neonates were classified into three groups according to the Bell's Staging Criteria: NECⅠ(n=25), NECⅡ(n=11) and NEC Ⅲ(n=25). Data on gestational age at birth, gender, birth weight, clinical manifestations, treatment and prognosis of the patients were collected. Radiographic assessment scale scores were evaluated by a pediatric radiologist.
Radiographic assessment scale scores in the NECⅠ, NECⅡand NEC Ⅲ groups were 3.2±1.4, 5.3±1.7 and 8.9±1.7, respectively (P<0.05). The score was highest in the NEC Ⅲ group and lowest in the NECⅠgroup. Based on the different therapies, the NEC Ⅲ group was subdivided into operative and non-operative groups. Radiographic assessment scale scores in the two subgroups were 8.71±1.86 and 9.36±1.21 respectively (P>0.05). Radiographic assessment scale scores in neonates with intestinal perforation (9.6±1.1) were higher than in those with intestinal necrosis (6.8±1.8) (P<0.05). The majority of patients (80%) who underwent operation had radiographic assessment scale scores above 7. The effective rate was 96% and 64% respectively in the NECⅠand the NECⅡ groups. Of the children in the NECⅢ group, the cure rate was 71% in the operative group, and the effective rate was 9% in the non-operative group.
The radiographic assessment scale may be used to evaluate the severity of disease in neonates with NEC. Patients with a score on the radiographic assessment scale above 7 have indications for surgical intervention and have better short-term treatment response rates.
本研究旨在确定影像学评估量表在新生儿坏死性小肠结肠炎诊断中的价值，并通过手术需求进行衡量。
根据贝尔分期标准，将61例新生儿分为三组：NECⅠ组（n = 25）、NECⅡ组（n = 11）和NECⅢ组（n = 25）。收集患者的出生孕周、性别、出生体重、临床表现、治疗及预后等数据。由儿科放射科医生评估影像学评估量表评分。
NECⅠ组、NECⅡ组和NECⅢ组的影像学评估量表评分分别为3.2±1.4、5.3±1.7和8.9±1.7（P<0.05）。评分在NECⅢ组最高，在NECⅠ组最低。根据不同治疗方法，将NECⅢ组细分为手术组和非手术组。两个亚组的影像学评估量表评分分别为8.71±1.86和9.36±1.21（P>0.05）。肠穿孔新生儿的影像学评估量表评分（9.6±1.1）高于肠坏死新生儿（6.8±1.8）（P<0.05）。接受手术的大多数患者（80%）影像学评估量表评分高于7分。NECⅠ组和NECⅡ组的有效率分别为96%和64%。NECⅢ组患儿中，手术组治愈率为71%，非手术组有效率为9%。
影像学评估量表可用于评估新生儿坏死性小肠结肠炎的疾病严重程度。影像学评估量表评分高于7分的患者有手术干预指征，且短期治疗有效率更高。
