论文部分内容阅读
目的本文的目的在于探讨不同分期新生儿坏死性小肠结肠炎(NEC)的高危因素特点及相应的诊疗措施。方法回顾性分析2010年1月1日至2013年1月1日入住本院NICU的91例NEC患儿的临床资料,用以比较NEC不同分期即疑似、确诊及死亡病例的相对危险因素、临床特点、实验室检查结果以及并发症等方面的特点。结果 91例NEC患儿中,Ⅰ期(疑似)患儿21例(23.07%),Ⅱ期患儿48例(52.74%),Ⅲ期患儿22例(包括手术患儿9例)(24.17%)。其中死亡患儿17例,病死率为18.68%。死亡病例中74%患儿在NEC发生后7 d内死亡,包括足月儿及早产儿。单因素分析结果表明:小胎龄和低出生体重是NEC死亡的主要高危因素(P<0.05),其次,死亡病例患儿诊断前、后多需辅助机械通气(P<0.01)、禁食时间短(P<0.05)、抗生素治疗时间短(P<0.01)。死亡患儿多合并呼吸暂停、短肠综合征、腹膜炎、DIC、神经系统后遗症(均P<0.05),提示死亡NEC患儿多合并其他严重疾病。结论 NEC死亡率高,进展快,易出现其他严重并发症,死亡迅速。死亡原因主要与不成熟、低体重、疾病严重程度有关。
Purpose The purpose of this article is to investigate the characteristics of high-risk factors and corresponding diagnosis and treatment of neonatal necrotizing enterocolitis (NEC) in different stages. Methods The clinical data of 91 patients with NEC admitted to NICU from January 1, 2010 to January 1, 2013 were retrospectively analyzed to compare the relative risk factors of suspected, confirmed and died NEC cases at different stages, Features, laboratory tests and complications and other aspects of the characteristics. Results Among 91 cases of NEC, 21 cases (23.07%) were in stage Ⅰ (suspected), 48 cases (52.74%) in stage Ⅱ, 22 cases (including 9 cases) in stage Ⅲ (24.17% ). Among them, 17 cases of children died, the case fatality rate was 18.68%. Seventy-four percent of deaths were fatal within seven days of NEC, including term infants and premature infants. Univariate analysis showed that both small gestational age and low birth weight were the major risk factors for NEC death (P <0.05). Second, children with death were more likely to have assisted mechanical ventilation before and after diagnosis (P <0.01), fasting time Short (P <0.05), antibiotic treatment time was shorter (P <0.01). More deaths in children with apnea syndrome, short bowel syndrome, peritonitis, DIC, neurological sequelae (all P <0.05), suggesting that death of NEC more children with other serious diseases. Conclusion The mortality rate of NEC is high, the progress is fast, other serious complications are easy to occur and the death rate is rapid. The main cause of death and immature, low weight, disease severity.