患有依赖导管的先天性心脏病的新生儿坏死性小肠结肠炎的疑似情况：预后与风险因素
Necrotising enterocolitis suspicion in newborns with duct-dependent congenital heart disease: prognosis and risk factor.
作者信息
El Louali Fedoua, Prom Camille, Myriem Belghiti Alaoui, Gran Celia, Fouilloux Virginie, Lenoir Marien, Ligi Isabelle, Ovaert Caroline, Michel Fabrice
机构信息
Department of Paediatric and Congenital Cardiology, Timone Hospital, Aix-Marseille University, Marseille, France
Department of Paediatric Anaesthesia and Intensive Care, Timone Children Hospital, Aix-Marseille University, Marseille, France.
出版信息
BMJ Paediatr Open. 2024 Sep 15;8(1):e002520. doi: 10.1136/bmjpo-2024-002520.
INTRODUCTION
The main risk factors of necrotising enterocolitis (NEC) are prematurity and low birth weight. The aim of our study was to identify risk factors for NEC in patients with duct-dependent congenital heart disease (CHD).
STUDY DESIGN
Newborns with duct-dependent CHD and NEC were matched 1:1 to those without NEC. Matched criteria were gestational age, birth weight, antenatal versus postnatal diagnosis and type of CHD.
RESULTS
Twenty-three infants were included in each group. In the NEC group, mortality, length of intensive care unit stay and length of hospital stay were significantly higher (p=0.035; p<0.0001; p<0.0001). Lower diastolic blood pressure (DBP), negative flow balance, peritoneal dialysis and epinephrine-infusion were significantly associated with NEC (respectively, p=0.008, p=0.002, p=0.007, p=0.017). In multivariate analysis, DBP≤30 mm Hg remained the only independent risk factor of NEC (OR=8.70; 95% CI (1.46 to 53.50), p=0.019).
CONCLUSION
A DBP lower than 30 mm Hg was in our matched population of newborns with duct-dependent CHD, independently associated with NEC.
引言
坏死性小肠结肠炎（NEC）的主要危险因素是早产和低出生体重。我们研究的目的是确定导管依赖性先天性心脏病（CHD）患者发生NEC的危险因素。
研究设计
将患有导管依赖性CHD且发生NEC的新生儿与未发生NEC的新生儿按1:1进行匹配。匹配标准为胎龄、出生体重、产前与产后诊断以及CHD类型。
结果
每组纳入23例婴儿。在NEC组中，死亡率、重症监护病房住院时间和住院总时间显著更长（p = 0.035；p < 0.0001；p < 0.0001）。舒张压（DBP）较低、液体负平衡、腹膜透析和肾上腺素输注与NEC显著相关（分别为p = 0.008、p = 0.002、p = 0.007、p = 0.017）。多因素分析中，DBP≤30 mmHg仍然是NEC的唯一独立危险因素（OR = 8.70；95%CI（1.46至53.50），p = 0.019）。
结论
在我们匹配的患有导管依赖性CHD的新生儿人群中，DBP低于30 mmHg与NEC独立相关。
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