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目的探讨极低出生体重儿坏死性小肠结肠炎(NEC)的发生率和高危因素。方法回顾性分析我院2006年8月至2011年4月在重症监护室住院时间>24h的极低出生体重儿,按照是否合并NEC分为病例组和对照组,对两组进行21个相关单因素及多因素分析。结果 323例极低出生体重儿发生Ⅱ期以上NEC20例,发生率6.2%。单因素分析显示,病例组医院感染败血症(χ2=29.449)、前置胎盘(χ2=6.648)、和先天性心脏病(χ2=11.353)的比例较对照组明显增加,早期微量喂养(χ2=8.355)的比例低于对照组,开奶时间较对照组延迟[8.5(3.3～15)天比3.0(2～7)天,Z=2.921],P均<0.05。多因素Logistic回归分析显示,医院感染败血症(OR9.050,95%CI3.272～25.030)、前置胎盘(OR6.841,95%CI1.491～31.392)和开奶延迟(OR1.065,95%CI1.007～1.127)是NEC发病的高危因素(P均<0.05)。结论医院感染败血症、前置胎盘、延迟开奶是NEC发病的危险因素。尽早开展微量喂养,积极预防极低出生体重儿医院感染,有助于降低NEC发生率。
Objective To investigate the incidence and risk factors of necrotizing enterocolitis (NEC) in very low birth weight infants. Methods A retrospective analysis of our hospital from August 2006 to April 2011 in intensive care unit hospitalization> 24h very low birth weight children, according to whether the merger NEC case group and control group, the two groups of 21 related single Factors and multivariate analysis. Results 323 cases of very low birth weight infants with stage Ⅱ and over 20 cases of NEC, the incidence rate of 6.2%. Univariate analysis showed that the proportion of nosocomial sepsis (χ2 = 29.449), placenta previa (χ2 = 6.648), and congenital heart disease (χ2 = 11.353) was significantly higher in the case group than in the control group (χ2 = 8.355 ) Was lower than the control group. The time of opening milk was delayed (8.5 (3.3-15) days vs. 3.0 (2-7) days, Z = 2.921], P <0.05. Multivariate Logistic regression analysis showed that nosocomial sepsis (OR9.050,95% CI3.272 ~ 25.030), placenta previa (OR6.841,95% CI1.491 ~ 31.392) and open milk delay (OR1.065,95 % CI1.007 ~ 1.127) were the risk factors of NEC (all P <0.05). Conclusion Hospital infection sepsis, placenta previa, delayed opening milk is a risk factor for the pathogenesis of NEC. As soon as possible to carry out micro-feeding, active prevention of very low birth weight hospital infection, help to reduce the incidence of NEC.