患有外科坏死性小肠结肠炎的早产儿小脑损伤的临床关联
Clinical Correlates of Cerebellar Injury in Preterm Infants with Surgical Necrotizing Enterocolitis.
作者信息
Garg Parvesh Mohan, Pittman Isabella, Taylor Charlotte, Reddy Kartik, Varshney Neha, Hillegass William B, Shetty Avinash, Yi Joe, Inder Terrie, Garg Padma
机构信息
Wake Forest University.
University of Mississippi medical Center.
出版信息
Res Sq. 2023 Dec 11:rs.3.rs-3720723. doi: 10.21203/rs.3.rs-3720723/v1.
OBJECTIVE
Determine the risk factors of cerebellar injury in infants with surgical necrotizing enterocolitis (NEC).
METHODS
Retrospective study compared clinical/pathological information between surgical NEC infants with and those without cerebellar injury.
RESULTS
Infants with cerebellar injury (21/65, 32.3%) had significantly more hemorrhagic and the reparative lesions on the intestinal histopathology, had patent ductus arteriosus (PDA) more often, received red cell transfusion frequently, had blood culture positive sepsis and grew gram positive organisms more often and had cholestasis frequently following NEC than those without cerebellar injury. On multilogistic regression, the positive blood culture sepsis (OR 3.9, CI 1.1-13.7, p = 0.03), PDA (OR 4.5, CI 1.0-19.9, p = 0.04) and severe hemorrhage (grade 3-4)(OR 16.9, CI 2.1-135.5, p = 0.007) were independently associated with higher risk of cerebellar injury.
CONCLUSION
The cerebellar injury was most likely associated with positive blood culture sepsis following NEC, PDA, and severe hemorrhage lesions (grade 3-4) in infants with surgical NEC.
目的
确定手术治疗的坏死性小肠结肠炎（NEC）患儿发生小脑损伤的危险因素。
方法
回顾性研究比较了发生小脑损伤和未发生小脑损伤的手术治疗的NEC患儿的临床/病理信息。
结果
与未发生小脑损伤的患儿相比，发生小脑损伤的患儿（21/65，32.3%）在肠道组织病理学上有更多的出血性和修复性病变，动脉导管未闭（PDA）更为常见，频繁接受红细胞输血，血培养阳性败血症更为常见且革兰氏阳性菌生长更为频繁，NEC后胆汁淤积更为常见。多因素逻辑回归分析显示，血培养阳性败血症（比值比[OR]3.9，可信区间[CI]1.1 - 13.7，p = 0.03）、PDA（OR 4.5，CI 1.0 - 19.9，p = 0.04）和严重出血（3 - 4级）（OR 16.9，CI 2.1 - 135.5，p = 0.007）与小脑损伤风险较高独立相关。
结论
手术治疗的NEC患儿发生小脑损伤很可能与NEC后的血培养阳性败血症、PDA以及严重出血性病变（3 - 4级）有关。
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