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[坏死性小肠结肠炎:一项为期10年的调查]

[Necrotizing enterocolitis: a 10-year survey].

作者信息

Gómez Tellado M, García Fernández E, País Piñeiro E, Vela Nieto D, Gallego Pastoriza M, Rios Tallón J, Pérez-Lafuente Leiro G, Dargallo Carbonell T, Candal Alonso J

机构信息

Servicio de Cirugia Pediátrica, Hospital Materno-Infantil Teresa Herrerá, La Coruña.

出版信息

Cir Pediatr. 1995 Jan;8(1):20-3.

PMID:7766469
Abstract

We reviewed the records of all infants with necrotizing enterocolitis (NEC) who had been diagnosed in "Teresa Herrera" Hospital in La Coruña between 1984 and 1994. We tried to determine the risk factors that could influence at the beginning of the disease, the clinic presentation, and the basic aspects of treatment. All cases of ECN with clinic-radiologic confirmation were examined (Bell stages II and III). With this approach, a general questionnaire containing records, clinical presentation, and treatment, was applied to all cases. In our revision, we found that neonate most at risk is that one with an average gestational age of 35 weeks, a mean weight of 2500 gr., with a laborious delivery and who was admitted in the neonatal intensive care unit for an important disease. The onset of NEC was more frequent in the first 15 days of life, and clinical and radiological features were used to confirm the disease. In 86% of the cases, oral feeding had begun. Surgery was needed in 36% of the cases, of which 86% suffered from gut perforation, terminal ileum being the most frequent localization. The general mortality was 12%. Only one of the operated patient died. We conclude that in the appearance of NEC there are a lot of influential factors, including perinatal stress, prematurity and a low birth weight. Clinical symptoms are haemodynamic instability, abdominal distension and bloody stools, obtaining confirmation through radiology in 87%. We consider the importance of early diagnosis and treatment and exhaustive observation by children's surgeon to indicate early surgery.

摘要

我们回顾了1984年至1994年间在拉科鲁尼亚的“特蕾莎·埃雷拉”医院被诊断为坏死性小肠结肠炎(NEC)的所有婴儿的记录。我们试图确定在疾病初期可能产生影响的风险因素、临床表现以及治疗的基本方面。对所有经临床-放射学确诊的坏死性小肠结肠炎病例(贝尔分期II期和III期)进行了检查。通过这种方法,我们向所有病例发放了一份包含记录、临床表现和治疗情况的通用问卷。在我们的回顾中,我们发现最易患坏死性小肠结肠炎的新生儿是那些平均胎龄为35周、平均体重为2500克、分娩困难且因重大疾病入住新生儿重症监护病房的婴儿。坏死性小肠结肠炎在出生后的前15天内发病更为频繁,通过临床和放射学特征来确诊该疾病。在86%的病例中,已经开始进行经口喂养。36%的病例需要进行手术,其中86%患有肠道穿孔,最常见的穿孔部位是回肠末端。总体死亡率为12%。接受手术的患者中只有一人死亡。我们得出结论,坏死性小肠结肠炎的发病存在许多影响因素,包括围产期应激、早产和低出生体重。临床症状包括血流动力学不稳定、腹胀和血便,87%的病例通过放射学检查得以确诊。我们认为早期诊断和治疗以及小儿外科医生进行详尽观察以指示早期手术的重要性。

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