Department of Neonatology, Rigshospitalet, Copenhagen, Denmark.
Department of Diagnostic Radiology, Rigshospitalet, Copenhagen, Denmark.
Acta Paediatr. 2019 May;108(5):842-848. doi: 10.1111/apa.14469. Epub 2018 Jul 10.
Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation.
We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets.
We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation.
An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.
坏死性小肠结肠炎（NEC）常根据 Bell 1978 分期系统进行分期，但如今的 NEC 病例比用于制定 Bell 分期的病例更为不成熟。我们的目的是探讨当代 NEC 和自发性肠穿孔病例的临床和影像学表现。
我们对丹麦哥本哈根 Rigshospitalet 新生儿科 2006-2015 年出生的所有 I-III 期 NEC 和自发性肠穿孔病例的临床记录进行编码，针对发病和高峰时的 16 个临床和影像学症状及体征进行分析。这些变量采用主成分分析进行探索，该方法可以在大型数据集检测模式。
我们回顾了 640 份临床记录，纳入了 158 例 NEC 或自发性肠穿孔病例。当我们输入疾病高峰时的临床和影像学表现时，除了一小部分 III 期 NEC 病例与自发性肠穿孔病例分组外，病例大致根据 Bell 分期分组。
对 2006-2015 年 NEC 病例的临床和影像学表现模式的分析支持 Bell 1978 分期系统。然而，NEC 和自发性肠穿孔的分离仍然是一项艰巨的任务。
