Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Division of Paediatric Surgery, Stellenbosch University, Cape Town, South Africa.
J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa130.
The aim of this study is to describe the 30-day mortality, neurodevelopmental outcome and composite outcome (mortality or abnormal neurodevelopmental outcome) of neonates with necrotizing enterocolitis (NEC), requiring neonatal intensive care (NICU) admission, in a resource-restricted environment.
All neonates admitted to Tygerberg Hospital, NICU, with a presumptive diagnosis of NEC Bell stage IIB or more, over a 5-year period, were included.
One hundred and thirty-five neonates were included with a mean gestational age of 29 ± 2.7 weeks and mean birth weight of 1185 g ± 446 g. The 30-day mortality was 52%, neurodevelopment abnormalities occurred in 35% of survivors and adverse composite outcome in 63%. The 30-day mortality and adverse composite outcome risk were increased by small for gestational age, shock, metabolic acidosis, inotrope requirement and first feed >9 days after surgery.
In resource-restricted environments, mortality and abnormal neurodevelopmental outcome of neonates with NEC, remain high. However, outcomes are comparable with international literature. Neonates with NEC, requiring NICU admission and surgery, require neurodevelopmental follow-up.
本研究旨在描述资源有限环境中，需要新生儿重症监护（NICU）治疗的坏死性小肠结肠炎（NEC）新生儿的 30 天死亡率、神经发育结局和复合结局（死亡率或异常神经发育结局）。
在 5 年期间，纳入所有在泰格尔伯格医院 NICU 以疑似 NEC Bell ⅡB 期或更严重程度入院的新生儿。
共纳入 135 例新生儿，平均胎龄为 29±2.7 周，平均出生体重为 1185±446 克。30 天死亡率为 52%，幸存者中有 35%出现神经发育异常，不良复合结局发生率为 63%。小于胎龄、休克、代谢性酸中毒、儿茶酚胺类药物需求以及手术后首次喂养时间>9 天增加了 30 天死亡率和不良复合结局的风险。
在资源有限的环境中，患有 NEC 的新生儿的死亡率和异常神经发育结局仍然很高。然而，其结局与国际文献报道相当。需要 NICU 治疗和手术的 NEC 新生儿需要进行神经发育随访。
