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新生儿坏死性小肠结肠炎预后的危险因素:82例分析

[Risk factors for prognosis of neonatal necrotizing enterocolitis: an analysis of 82 cases].

作者信息

Yu Lun, Sun Bin, Miao Po, Feng Xing

机构信息

Department of Neonatology, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu 215000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2013 Dec;15(12):1082-5.

Abstract

OBJECTIVE

To study the risk factors for prognosis of neonatal necrotizing enterocolitis (NEC).

METHODS

A retrospective analysis was performed on the clinical data of 82 neonates with NEC confirmed between January 2008 and October 2012. The possible prognostic factors in NEC were investigated by logistic regression analysis.

RESULTS

In the 82 cases of NEC, the cure rate decreased with the aggravation of condition (P<0.05). The preterm infants had a significantly higher incidence of NEC than the full-term infants at three or more weeks after birth (P=0.004). The univariate analysis showed that the prognosis of NEC was related to the factors such as sepsis, congenital heart disease, scleredema, peritonitis, metabolic acidosis, hyponatremia, leukocyte disorder, thrombocytopenia, elevated C-reactive protein, and severe abdominal X-ray abnormalities (P<0.05), and the further logistic regression analysis revealed that congenital heart disease, scleredema, and metabolic acidosis were main risk factors for the clinical outcome of NEC (P<0.05).

CONCLUSIONS

The onset time of NEC is correlated with gestational age in neonates. There are multiple prognostic factors in NEC; special attention should be paid to the patients with congenital heart disease, scleredema, and metabolic acidosis so that early intervention is performed to reduce mortality.

摘要

目的

研究新生儿坏死性小肠结肠炎(NEC)预后的危险因素。

方法

对2008年1月至2012年10月确诊的82例NEC新生儿的临床资料进行回顾性分析。通过逻辑回归分析探讨NEC可能的预后因素。

结果

82例NEC患儿中,治愈率随病情加重而降低(P<0.05)。早产儿出生三周及以后NEC发病率显著高于足月儿(P=0.004)。单因素分析显示,NEC预后与败血症、先天性心脏病、硬肿症、腹膜炎、代谢性酸中毒、低钠血症、白细胞紊乱、血小板减少、C反应蛋白升高及腹部X线严重异常等因素有关(P<0.05),进一步逻辑回归分析显示先天性心脏病、硬肿症和代谢性酸中毒是NEC临床结局的主要危险因素(P<0.05)。

结论

NEC发病时间与新生儿胎龄相关。NEC存在多种预后因素;应特别关注先天性心脏病、硬肿症和代谢性酸中毒患者,以便进行早期干预降低死亡率。

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