补充肠外营养对早产、低出生体重新生儿坏死性小肠结肠炎结局的影响。

The effect of supplemental parenteral nutrition on outcomes of necrotizing enterocolitis in premature, low birth weight neonates.

作者信息

Akinkuotu Adesola C, Nuthakki Sushma, Sheikh Fariha, Cruz Stephanie M, Welty Stephen E, Olutoye Oluyinka O

机构信息

The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030, USA.

出版信息

Am J Surg. 2015 Dec;210(6):1045-9; discussion 1049-50. doi: 10.1016/j.amjsurg.2015.08.004. Epub 2015 Sep 14.

DOI:10.1016/j.amjsurg.2015.08.004

PMID:26518162

Abstract

BACKGROUND

We hypothesized that supplemental parenteral nutrition (PN) decreases the need for surgery and mortality associated with necrotizing enterocolitis (NEC).

METHODS

Single institution retrospective review of all premature, low birth weight infants with NEC from January 2006 to December 2013 was conducted.

RESULTS

NEC was identified in 114 premature, low birth weight infants, 59 (51.8%) of which required surgical management. Surgical NEC infants were born younger (25.8 ± 4.0 vs 27.8 ± 3.3 weeks, P = .005) and weighed less at birth (829 ± 281 vs 938 ± 271 g, P = .038) than those managed medically. There was no difference in the use of PN (37.7% vs 31.4%, P = .541) between surgical and medical NEC patients. There was no statistically significant difference in mortality at discharge between patients who had PN at NEC onset and those who did not (31.4% vs 42.6%, P = .294) CONCLUSION: In this single-center study, supplemental PN at NEC onset does not appear to significantly improve outcomes as demonstrated by rates of surgical intervention and in-hospital mortality.

摘要

背景

我们推测补充肠外营养（PN）可降低坏死性小肠结肠炎（NEC）相关的手术需求和死亡率。

方法

对2006年1月至2013年12月期间所有患有NEC的早产低体重婴儿进行单机构回顾性研究。

结果

在114例早产低体重婴儿中确诊为NEC，其中59例（51.8%）需要手术治疗。手术治疗的NEC婴儿出生时孕周更小（25.8±4.0周对27.8±3.3周，P = 0.005），出生体重更低（829±281克对938±271克，P = 0.038），与非手术治疗的婴儿相比。手术和非手术治疗的NEC患者在PN使用方面无差异（37.7%对31.4%，P = 0.541）。NEC发病时接受PN治疗的患者与未接受PN治疗的患者出院时死亡率无统计学显著差异（31.4%对42.6%，P = 0.294）。结论：在这项单中心研究中，NEC发病时补充PN似乎并未如手术干预率和住院死亡率所示显著改善预后。