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目的探讨腹部X线量表评分在新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)中的应用。方法 2012年在我院新生儿科住院的日龄<28天的足月儿或者纠正胎龄<42周的早产儿中,222例疑诊或确诊NEC,搜集其临床资料进行回顾性研究,腹部X线量表进行腹片评分。结果 BellⅠ期、Ⅱ期、Ⅲ期患儿腹片评分分别为(3.72±1.634)分,(5.49±1.882)分和(8.84±2.375)分,各期评分差异均具有统计学意义(P=0.000);治愈率分别为66.7%(78/117),53.9%(41/76)和20.0%(5/25),Ⅰ期与Ⅱ期治愈率较Ⅲ期差异有统计学意义(P<0.05)。Logistic回归提示,Bell分期(χ1)、败血症(χ2)与NEC预后密切相关:y=0.804χ1+1.002χ2-2.940。结论腹部X线量表评分随NEC病情加重而升高,一定程度上量化腹片异常的严重程度,更好地指导临床诊疗。
Objective To investigate the application of abdominal X-ray score in neonatal necrotizing enterocolitis (NEC). Methods Twenty-two cases of suspected or confirmed NEC in full-term infants younger than 28 days or neonates with gestational age <42 weeks who were hospitalized in neonatology department of our hospital in 2012 were retrospectively studied. The clinical data of abdomen X Line scale abdominal score. Results The results of Bell Ⅰ, Ⅱ, and Ⅲ belts were (3.72 ± 1.634) points, (5.49 ± 1.882) points and (8.84 ± 2.375) points, respectively, with significant difference in each stage (P = 0.000 ). The cure rates were 66.7% (78/117), 53.9% (41/76) and 20.0% (5/25) respectively. The cure rates of stage Ⅰ and stage Ⅱ were significantly different from those of stage Ⅲ (P0.05) . Logistic regression indicated that Bell staging (χ1) and sepsis (χ2) were closely related to the prognosis of NEC: y = 0.804χ1 + 1.002χ2-2.940. Conclusion The abdomen X-ray score increased with the severity of NEC. To a certain extent, the severity of abdominal abnormalities was quantified to better guide clinical diagnosis and treatment.