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新生儿坏死性小肠结肠炎的临床特点与结局分析
Clinical features and outcomes of neonatal necrotizing enterocolitis
目的 分析新生儿坏死性小肠结肠炎（NEC）临床特点及结局的危险因素。方法 回顾性分析诊断为NEC的121例早产儿的临床资料，根据治疗方式分为非手术组（n=66）与手术组（n=55），根据结局分为存活组（n=76）与死亡组（n=45），比较各组新生儿的临床特征并分析结局相关危险因素。结果 手术组发生NEC时纠正胎龄、血小板最低值、血便发生率低于非手术组（P < 0.05），发生NEC时C-反应蛋白最高值、病死率高于非手术组（P < 0.05）。死亡组出生胎龄、出生体重、小于胎龄儿比例及发生NEC时纠正胎龄、体重、血小板最低值低于存活组（P < 0.05）；死亡组动脉导管未闭发生率、布洛芬使用率、发生NEC时C-反应蛋白最高值及手术治疗率高于存活组（P < 0.05）。多因素logistic回归分析显示，使用布洛芬是NEC死亡的危险因素（OR=9.149，P < 0.05）。结论 使用布洛芬是早产儿NEC死亡的危险因素。
Objective To study the clinical features of neonatal necrotizing enterocolitis (NEC) and risk factors for poor outcomes. Methods A retrospective analysis was performed for the clinical data of 121 preterm infants diagnosed with NEC. According to the treatment method, they were divided into a non-surgical group (n=66) and a surgical group (n=55). According to the outcome, they were divided into a survival group (n=76) and a death group (n=45). Clinical features were compared between these groups. Risk factors for poor outcomes were analyzed by multivariate logistic regression analysis. Results Compared with the non-surgical group, the surgical group had significantly lower corrected gestational age, minimum platelet count, and incidence rate of bloody stool at the onset of NEC (P < 0.05). The maximum C-reactive protein (CRP) and mortality rate in the surgical group were significantly higher than those in the non-surgical group (P < 0.05). Compared with the survival group, the death group had significantly lower gestational age at birth, birth weight, proportion of small-for-gestational-age infants, and corrected gestational age, body weight and minimum platelet count at the onset of NEC (P < 0.05). The incidence of patent ductus arteriosus, rate of use of ibuprofen, maximum CRP and rate of surgical treatment in the death group were significantly higher than those in the survival group (P < 0.05). The multivariate logistic regression analysis showed that ibuprofen treatment was a risk factor for death in infants with NEC (OR=9.149, P < 0.05). Conclusions Ibuprofen treatment increases the risk for death in preterm infants with NEC.
Necrotizing enterocolitis / Outcome / Risk factor / Preterm infant
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