新生儿坏死性小肠结肠炎97例临床分析

发布时间：2018-11-12 09:38

【摘要】：目的探讨新生儿坏死性小肠结肠炎的临床特点、诊疗、预后及危险因素,为临床诊治及改善预后提供依据。 方法对广西医科大学第一附属医院新生儿科2003年1月-2012年12月收治的97例新生儿NEC患儿进行回顾性分析。分析NEC患儿发生率及临床资料。根据转归不同分成治愈组及预后不良组,比较两组与预后相关因素的差异,寻找影响预后的因素。采用SPSS13.0统计软件对数据进行处理,两样本率的比较使用卡方检验、确切概率法,以及多因素Logistic回归分析。 结果97例NEC10年发生率为1.1%,2003-2007年5年发生率为1.6%,2008-2012年5年发生率为0.8%。前后5年的发生率比较有统计学差异。早产儿78例(80.4%),足月儿19例(19.6%),平均胎龄(33.0±4.94)周,平均出生体重2131±723.54g。治愈79例,预后不良18例。NEC Ⅰ期20例,治愈率95.0%,Ⅱ期55例,治愈率72.7%,Ⅲ期22例,治愈率59.0%。单因素分析：早产、低出生体重、人工喂养、败血症、肺炎、呼吸暂停、硬肿症、休克、腹膜炎、高血糖、代谢性酸中毒、DIC、肠穿孔、肠道畸形、腹部X线异常、Bell分期与NEC预后不良有关。进行多因素分析,提示早产、败血症、代谢性酸中毒是影响预后的高危因素。 结论(1)NEC患儿以早产儿,低出生体重儿,小于胎龄儿,人工喂养儿,增加奶量速度20ml/kg.d的新生儿多见。(2)NEC的预后与早产、低出生体重、人工喂养、败血症、肺炎、呼吸暂停、硬肿症、休克、腹膜炎、高血糖、代谢性酸中毒、DIC、肠穿孔、肠道畸形、腹部X线异常有关。(3) Bell分期越差,预后越差。(4)早产、败血症、代谢性酸中毒是影响预后的重要因素。
[Abstract]:Objective to investigate the clinical features, diagnosis and treatment, prognosis and risk factors of neonatal necrotizing enterocolitis. Methods 97 neonates with NEC admitted from January 2003 to December 2012 in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The incidence and clinical data of children with NEC were analyzed. According to the outcome, the patients were divided into two groups: the cured group and the poor prognosis group. The difference between the two groups and the prognostic factors was compared, and the factors affecting the prognosis were found. The data were processed by SPSS13.0 statistical software. The comparison of the two sample rates was carried out by chi-square test, exact probability method and multivariate Logistic regression analysis. Results the annual incidence rate of 97 cases of NEC10 was 1.1%. The incidence rate of 5 years from 2003 to 2007 was 1.6 years, and the incidence rate of 2008 to 2012 was 0.8 years. There was a statistical difference in the incidence between the two groups in 5 years. There were 78 premature infants (80.4%) and 19 term infants (19.6%). The average gestational age was (33.0 卤4.94) weeks and the average birth weight was 2131 卤723.54 g. 79 cases were cured and 18 cases had poor prognosis. The cure rate was 95.0 in NEC 鈪，

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