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目的寻找新生儿坏死性小肠结肠炎(NEC)早期诊断、早期识别的指标,以利于早期干预。方法新生儿科及新生儿外科确诊早期NEC患儿36例,在住院期间出现腹胀、腹壁红肿而确诊NEC。所有早期NEC患儿均检查血常规、C-反应蛋白、大便潜血、腹部立卧位片彩色多普勒检查。结果 30例经过治疗后痊愈出院,其中1例1个月后发生肠粘连梗阻再次手术;4例发展为晚期NEC,3例给予肠造瘘或肠切除吻合术,1例全小肠坏死,术后死亡;2例以肺炎败血症入院的患儿很快进入晚期NEC,术中发现均为全部小肠坏死,给予腹腔引流,术后均放弃治疗。结论新生儿坏死性小肠结肠炎早期诊断应立足于新生儿特别是早产儿高危因素筛查,对于缺氧窒息、感染、腹胀、便血等高危患儿,应综合判断,早期给予禁食,对症处理,从而可以避免许多患儿发展为中晚期NEC。
Objective To search for the indicators of early diagnosis and early identification of neonatal necrotizing enterocolitis (NEC) in order to facilitate early intervention. Methods Thirty-six neonates with early-stage NEC diagnosed in neonatology and neonates were diagnosed with NEC by abdominal distension and abdominal wall swelling during hospitalization. All patients with early NEC were examined by blood routine, C-reactive protein, fecal occult blood and color Doppler ultrasound examination of the abdomen. Results Thirty patients were cured and discharged after treatment. Among them, one patient had reoperation of intestinal adhesion obstruction after one month, four patients developed advanced NEC, three patients underwent enterostomy or intestine resection and anastomosis, and one patient had total intestinal necrosis. Died; 2 cases of children admitted to hospital with pneumonia sepsis soon entered the late NEC, were found in all intraoperative necrosis of the small intestine, abdominal drainage, were given up after treatment. Conclusion Neonatal neonatal necrotizing enterocolitis early diagnosis should be based on screening neonatal high risk factors in particular premature children for hypoxic asphyxia, infection, abdominal distension, blood in the stool and other high-risk children should be comprehensive judgments, early given fasting, symptomatic treatment , Which can prevent many children with advanced NEC.