新生儿坏死性小肠结肠炎的危险因素及预后
Risk factors and outcome in neonatal necrotising enterocolitis.
作者信息
Gane Bahubali, Bhat B Vishnu, Adhisivam B, Joy Rojo, Prasadkumar P, Femitha P, Shruti B
机构信息
Division of Neonatology, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India.
出版信息
Indian J Pediatr. 2014 May;81(5):425-8. doi: 10.1007/s12098-013-1311-5. Epub 2014 Jan 4.
OBJECTIVES
To analyze multiple risk factors of necrotizing enterocolitis (NEC) and the outcome.
METHODS
Hundred neonates with NEC were compared with 100 normal neonates matched for sex, gestation and weight. Their data including antenatal, natal, course of illness, hospital stay, progress and outcome were collected. Univariate analysis and logistic regression were used to analyze the risk factors.
RESULTS
Mean age of onset of NEC was 2.35 ± 1.11 d. Stage I, II and III were noted in 48 %, 39 % and 13 % of cases respectively. Most common clinical features were abdominal distension (85 %) and feed intolerance (70 %). Important risk factors associated with NEC were sepsis, top feeding, perinatal asphyxia, respiratory distress and mechanical ventilation. Antenatal steroids and breast feeding had beneficial effect. No association was found with occurrence of NEC and cyanotic heart disease or administration of H2 blockers. Outcome in stage III was very poor.
CONCLUSIONS
Early identification of risk factors and appropriate intervention may reduce the incidence and improve the outcome in NEC.
目的
分析坏死性小肠结肠炎（NEC）的多种危险因素及预后。
方法
将100例NEC新生儿与100例性别、孕周和体重匹配的正常新生儿进行比较。收集他们的产前、产时、病程、住院时间、病情进展及预后等数据。采用单因素分析和逻辑回归分析危险因素。
结果
NEC的平均发病年龄为2.35±1.11天。分别有48%、39%和13%的病例为I期、II期和III期。最常见的临床特征是腹胀（85%）和喂养不耐受（70%）。与NEC相关的重要危险因素有败血症、经口喂养、围产期窒息、呼吸窘迫和机械通气。产前使用类固醇和母乳喂养有有益作用。未发现NEC的发生与先天性心脏病或使用H2阻滞剂有关。III期的预后非常差。
结论
早期识别危险因素并进行适当干预可能降低NEC的发病率并改善其预后。
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