早产儿坏死性小肠结肠炎的临床特征及影响因素的初步分析

发布时间：2018-07-17 04:43

【摘要】：目的：探讨早产儿坏死性小肠结肠炎的临床特征及影响因素,进行必要的干预,减少暴露机会,降低NEC的发病率。方法：依照纳入及排除标准选择2010年1月1日-2013年06月30日入住新疆医科大学第一附属医院新生儿科1327例早产儿及其中发生NEC的87例患儿进行回顾性病例对照研究。对其临床特征进行统计描述、推断及Logistic回归分析其影响因素。结果：①早产儿NEC发病率为6.56%,其中极低出生体重儿发病率高达19%。临床表现以胃潴留、腹胀及肠鸣音减弱为主要表现。②与未发生NEC的早产儿相比,早产儿坏死性小肠结肠炎在胎龄(t=-2.353,P0.05)、出生体重(t=-3.398,P0.05)间分布有统计学差异,而在性别(x2=1.269,P=0.26)、民族(x2=3.795,P=0.284)间分布无统计学差异。③早产儿坏死性小肠结肠炎的严重程度(不同分期)在血小板降低(x2=9.419,P0.05)、CRP升高(x2=5.060,P0.05)、输血(x2=5.78,P0.05)间分布的差异有统计学意义,而在胎龄、出生体重间差异无统计学意义。④二分类Logistic回归分析显示出生体重(β=-0.001,P0.05,Exp(β)=0.999)、喂养方式(β=-9.190,P0.05,Exp(β)=0.000)、孕母疾病(β=3.237,P0.05,Exp(β)=25.469)、贫血(β=3.780,P0.05,Exp(β)=43.814)及输血(β=3.328,P0.05,Exp(β)=27.894)与早产儿坏死性小肠结肠炎的发生有关。结论：早产儿坏死性小肠结肠炎是临床上新生儿重症监护室内常见的胃肠道疾病,且出生体重越低、胎龄越小,发病率越高。其中出生体重、喂养方式(母乳喂养)为其保护性因素,而孕母疾病、贫血、输血则为其危险性因素,需积极预防及正确干预。
[Abstract]:Objective: to investigate the clinical characteristics and influencing factors of necrotizing enterocolitis in premature infants, and to make necessary intervention to reduce the chance of exposure and the incidence of NEC. Methods: according to the inclusion and exclusion criteria, a retrospective case-control study was conducted in 1327 premature infants and 87 children with NECs in the first affiliated Hospital of Xinjiang Medical University from January 1, 2010 to June 30, 2013. The clinical features were statistically described, inferred and logistic regression analysis were used to analyze the influencing factors. Results the incidence of NEC in premature infants was 6.56 and the incidence of very low birth weight infants was as high as 19. The main clinical manifestations were gastric retention, abdominal distension and decreased bowel tone. 2. Compared with premature infants without NEC, necrotizing enterocolitis of preterm infants was significantly different in gestational age (t = 2.353), birth weight (t = 3.398p. 05), and no significant difference was found in the distribution of necrotizing enterocolitis between preterm infants and preterm infants. However, there was no significant difference in the distribution of serum CRP between the two ethnic groups (x2P 1.269, P < 0.26) and ethnic groups (x2n 3.795). 3 the severity of necrotizing enterocolitis of premature infants (different stages) was significantly higher than that of blood transfusion (x2P 5.060, P 0.05), but at gestational age, there was no significant difference in the distribution of CRP in the patients with necrotizing enterocolitis (x2P 9.419 P 0.05) and blood transfusion (x2P 5.788 P 0.05), but in the gestational age, there was no significant difference in the distribution of CRP between the two groups. Logistic regression analysis showed that birth weight (尾 -0.001) P0.05Exp (尾) 0.999, feeding pattern (尾 -9.190 P0.05Exp (尾) 0.000), maternal diseases (尾 -3.237P0.05Exp (尾) 25.469), anemia (尾 3.780P0.05Exp (尾) 43.814) and blood transfusion (尾 3.328P0.05Exp (尾) 27.894) were associated with the development of necrotizing enteritis in preterm infants. Conclusion: necrotizing enterocolitis of premature infants is a common gastrointestinal disease in neonatal intensive care unit. The lower the birth weight and the smaller the gestational age, the higher the incidence. Birth weight and feeding mode (breast-feeding) are the protective factors, while maternal diseases, anemia and blood transfusion are the risk factors.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R722.6

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