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目的探讨围生期因素、喂养方式、服用益生菌、发病前合并疾病及发病前接受机械通气等对新生儿坏死性小肠结肠炎(NEC)发病的影响,旨在提供NEC发生的高危因素。方法选取2011年1月至2016年1月于中国医科大学附属盛京医院第一新生儿病房住院治疗的76例NEC患儿为病例组,并随机选取同期住院的80例非NEC患儿为对照组。回顾性分析患儿的临床资料,包括新生儿一般情况、围生期情况、喂养方式、口服益生菌情况、发病前合并其他疾病情况及接受机械通气等19个项目,应用SPSS软件进行单因素及多因素分析。结果单因素分析结果显示,病例组合并窒息、败血症、低血糖以及接受机械通气的比例显著高于对照组,口服益生菌的比例显著低于对照组,差异具有统计学意义(P<0.05)。Logistic多元回归分析结果显示,败血症(OR=6.531)、低血糖(OR=2.785)、机械通气(OR=3.448)为NEC发病的危险因素,口服益生菌为NEC的保护因素(OR=0.417)。结论败血症、低血糖及机械通气为NEC发病的危险因素,口服益生菌为NEC的保护因素。临床上应合理分析这些影响因素,早期预防及干预NEC,以改善患儿预后。
Objective To investigate the influence of perinatal factors, feeding methods, probiotics, pre-morbid disease and mechanical ventilation before neonatal necrotizing enterocolitis (NEC) in order to provide high-risk factors for NEC. Methods From January 2011 to January 2016, 76 children with NEC admitted to the First Neonatal Ward of Shengjing Hospital Affiliated to China Medical University were selected as the case group and 80 non-NEC children hospitalized in the same period were selected as the control group. A retrospective analysis of clinical data in children, including neonatal general situation, perinatal conditions, feeding patterns, oral probiotics, pre-morbidity cases and other mechanical conditions and acceptance of 19 projects, the application of SPSS software for single factor and multi-factor analysis. Results The results of univariate analysis showed that the proportion of cases with asphyxia, sepsis, hypoglycemia and mechanical ventilation was significantly higher than that of the control group. The proportion of oral probiotics was significantly lower than that of the control group (P <0.05). Logistic multiple regression analysis showed that sepsis (OR = 6.531), hypoglycemia (OR = 2.785) and mechanical ventilation (OR = 3.448) were the risk factors for NEC. Oral probiotics were the protective factor of NEC (OR = 0.417). Conclusion Sepsis, hypoglycemia and mechanical ventilation are the risk factors of NEC. Oral probiotics are the protective factors of NEC. Clinically, these factors should be reasonably analyzed, and early prevention and intervention of NEC should be carried out to improve the prognosis of children.