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手术性坏死性小肠结肠炎术后结局的临床决定因素。

Clinical determinants of postoperative outcomes in surgical necrotizing enterocolitis.

机构信息

Department of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA.

Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

J Perinatol. 2020 Nov;40(11):1671-1678. doi: 10.1038/s41372-020-0728-8. Epub 2020 Jul 15.

Abstract

OBJECTIVE

Investigate predictors of postoperative morbidity and mortality in surgical NEC.

STUDY DESIGN

We analyzed the clinical outcomes of infants with surgical NEC from the years 2000-2015.

RESULTS

Ninety infants born at gestation (mean ± standard deviation, SD; standard error of mean, SEM) 27.3 ± 6.6 weeks (SEM ± 0.07 weeks) and weighing 1008 ± 456 g (SEM ± 48 g) developed NEC on 25.2 ± 22.4 days (SEM ± 2.4 days). Average bowel resection was 29.2 ± 30.5 cm (SEM ± 3.2 cm). Postoperative Ileus lasted 16.5 ± 12.2 days (SEM ± 1.3 days), and was significantly longer in infants with higher gestation and birth weight, age at onset of NEC, length of intestinal resection, maternal chorioamnionitis, and need for pressors. Thirty-eight (42.2%) infants died. Mortality was higher at gestation <31 weeks.

CONCLUSION

Gestational age, birth weight, age at NEC onset, and length of resected bowel determined postoperative morbidity and mortality in NEC. Length of hospital stay was affected by above factors, and also the duration of postoperative ileus and parenteral nutrition.

摘要

目的

研究手术性 NEC 患者术后发病率和死亡率的预测因素。

研究设计

我们分析了 2000 年至 2015 年期间患有手术性 NEC 的婴儿的临床结果。

结果

90 名胎龄为 27.3±6.6 周(SEM±0.07 周)、体重为 1008±456 克(SEM±48 克)的婴儿患有 NEC,发病时间为 25.2±22.4 天(SEM±2.4 天)。平均肠切除长度为 29.2±30.5 厘米(SEM±3.2 厘米)。术后肠梗阻持续 16.5±12.2 天(SEM±1.3 天),胎龄和出生体重较高、NEC 发病年龄、肠切除长度、母体绒毛膜羊膜炎和需要升压药的婴儿中,肠梗阻持续时间明显更长。38 名(42.2%)婴儿死亡。胎龄<31 周的死亡率更高。

结论

胎龄、出生体重、NEC 发病年龄和切除肠段的长度决定了 NEC 的术后发病率和死亡率。住院时间受上述因素以及术后肠梗阻和肠外营养的持续时间影响。

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