Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Nanjing Maternity and Child Health Care Hospital, Jiangsu, China.
J Pediatr Surg. 2022 Mar;57(3):382-386. doi: 10.1016/j.jpedsurg.2021.05.014. Epub 2021 May 29.
To describe the current incidence, case-fatality rate and surgical treatment proportion of necrotizing enterocolitis (NEC) among preterm infants in China.
The study included all live neonates with <34 weeks gestational age (GA) admitted to 25 tertiary hospitals within 7 days of birth from 19 provinces in China between May 2015 and April 2018. NEC was defined as ≥stage II according to Bell's criteria.
A total of 24,731 infants were included. The overall incidence of NEC was 3.3% and decreased with increasing GA and birth weight. The incidence of NEC was 4.8% in very preterm infants and 1.8% in infants born ≥32 weeks GA, respectively. The overall case-fatality rate of NEC was 9.5%, and the case-fatality rate was 7.0% among infants born ≥32 weeks GA. A total of 214 (27.9%) infants underwent surgery, and their overall case-fatality rate was 13.6%. Significant variation in the incidence of NEC existed among different centers (0.6-11.1%).
The incidence and case-fatality rate of NEC are high in China, especially among infants with GA ≥32 weeks, and varies significantly among sites. A high proportion of NEC infants required surgical management, with an even higher case-fatality rate.
描述中国早产儿中坏死性小肠结肠炎（NEC）的当前发病率、病死率和手术治疗比例。
本研究纳入了 2015 年 5 月至 2018 年 4 月期间中国 19 个省的 25 家三级医院出生后 7 天内的所有 <34 周胎龄（GA）的活产新生儿。根据 Bell 标准，将 NEC 定义为≥Ⅱ期。
共纳入 24731 例婴儿。NEC 的总发病率为 3.3%，随着 GA 和出生体重的增加而降低。非常早产儿的 NEC 发病率为 4.8%，GA≥32 周的婴儿发病率为 1.8%。NEC 的总病死率为 9.5%，GA≥32 周的婴儿病死率为 7.0%。共有 214 例（27.9%）婴儿接受了手术治疗，其总病死率为 13.6%。不同中心之间 NEC 的发病率存在显著差异（0.6-11.1%）。
中国 NEC 的发病率和病死率均较高，尤其是 GA≥32 周的婴儿，且各地区差异显著。很大比例的 NEC 婴儿需要手术治疗，病死率更高。
