Barguño Bassols J M, Figueras Aloy J, Botet Mussons F, Jiménez González R
Departamento de Pediatría, Hospital Clínico y Facultad de Medicina, Barcelona.
An Esp Pediatr. 1988 Jul;29(1):31-6.
Necrotizing enterocolitis is the most common digestive emergency in neonatal units. Several factors are involved in their pathogenesis: intestinal ischemia, bacterial colonization and feeding. To analyse these factors, 25 cases of NEC are compared to a control group of 48 newborns. Results showed an incidence of NEC about 1.6 0/00 live newborns, without a greater mortality in respect to other pathologic newborns. Ischemic factors influence significatively in appearance of ECN (p less than 0.001). None of them received maternal feeding. By this reason it seems to be a protective factor against bottle feeding (p less than 0.05). Enteral feeding its main influence upon mature newborns. No common bacterial findings have been found, but 68% of children developed clinical findings compatible with sepsis. Severity of abdominal sings in clinical examination in the acute phase of NEC is positively correlated with the presence of complications. Individual considerations are needed in sight to the different severity and prognosis of NEC.
坏死性小肠结肠炎是新生儿重症监护病房中最常见的消化系统急症。其发病机制涉及多个因素:肠道缺血、细菌定植和喂养。为分析这些因素,将25例坏死性小肠结肠炎患儿与48例新生儿对照组进行比较。结果显示,坏死性小肠结肠炎的发病率约为每1000例活产新生儿中有1.6例,相对于其他患病新生儿,死亡率并未更高。缺血因素对坏死性小肠结肠炎的出现有显著影响(p<0.001)。他们均未接受母乳喂养。因此,母乳喂养似乎是预防奶瓶喂养的一个保护因素(p<0.05)。肠内喂养对足月儿影响最大。未发现常见的细菌感染,但68%的患儿出现了与败血症相符的临床症状。坏死性小肠结肠炎急性期临床检查中腹部体征的严重程度与并发症的发生呈正相关。鉴于坏死性小肠结肠炎的不同严重程度和预后,需要进行个体化考量。