Clinical analysis of surgical intervention in the treatment of necrotizing enterocolitis in neonates

LIN Hui-Jia, MA Xiao-Lu, SHI Li-Ping, LUO Fang

Chinese Journal of Contemporary Pediatrics ›› 2012, Vol. 14 ›› Issue (12) : 906-909.

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Chinese Journal of Contemporary Pediatrics ›› 2012, Vol. 14 ›› Issue (12) : 906-909.

Clinical analysis of surgical intervention in the treatment of necrotizing enterocolitis in neonates

  • LIN Hui-Jia, MA Xiao-Lu, SHI Li-Ping, LUO Fang
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Abstract

OBJECTIVE: To evaluate the high-risk factors, prognostic factors, and operation time for surgical intervention in the treatment of necrotizing enterocolitis (NEC) in neonates. METHODS: Sixty-two NEC neonates who received treatment in the neonatal intensive care unit from October 2001 to October 2011 were enrolled. Patients were assigned to surgery (n=20) and non-surgery groups (n=42). The two groups were compared with respect to general data, complications, clinical symptoms, laboratory examination results, treatment and prognosis. RESULTS: Compared with non-surgery group, the surgery group had significantly higher rates of respiratory distress syndrome, gurgling sound disappearance, C-reactive protein increase, platelet count decrease, positive blood culture, pneumoperitoneum and fixed intestinal loop on X-ray, and mechanical ventilation (P<0.05). Cured patients in the surgery group had significantly lower rates of circulation failure and multiple bowel perforations than patients who died (P<0.05), as shown by the prognostic factor analysis. Of the 20 patients in the surgery group, 19 (95%) underwent operation within one week after diagnosis of NEC and 15 survived the operation. CONCLUSIONS: There are multiple risk factors in surgical intervention for NEC. Bowel lesions and circulation failure are associated with postoperative prognosis. The operation is usually performed within one week after diagnosis of NEC.

Key words

坏死性小肠结肠炎 / 手术 / 高危因素 / 预后 / 新生儿

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LIN Hui-Jia, MA Xiao-Lu, SHI Li-Ping, LUO Fang. Clinical analysis of surgical intervention in the treatment of necrotizing enterocolitis in neonates[J]. Chinese Journal of Contemporary Pediatrics. 2012, 14(12): 906-909

References

[1]金汉珍.新生儿坏死性小肠结肠炎[M]//胡亚美,江载芳.诸福棠实用儿科学(上册).第7版.北京:人民卫生出版社,2005:475.

[2]Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging[J].Ann Surg, 1978, 187(1): 1-7.

[3]Lin PW, Stoll BJ. Necrotising enterocolitis[J]. Lancet, 2006, 368(9543): 1271-1283.

[4]Thompson AM, Bizzarro MJ. Necrotizing enterocolitis in newborns: pathogenesis, prevention and management[J]. Drugs, 2008, 68(9): 1227-1238.

[5]Holman RC, Stoll BJ, Clarke MJ, Glass R. The epidemiology of necrotizing enterocolitis infant mortality in the United States[J]. Am J Public Health, 1997, 87(12): 2026-2031.

[6]Eltayeb AA, Mostafa MM, Ibrahim NH, Eltayeb AA. The role of surgery in management of necrotizing enterocolitis[J]. Int J Surg, 2010, 8(6): 458-461.

[7]Henry MC, Moss RL. Neonatal necrotizing enterocolitis[J]. Semin Pediatr Surg, 2008, 17(2): 98-109.

[8]Pourcyrous M, Korones SB, Yang W, Boulden TF, Bada HS. C-reactive protein in the diagnosisi, management, and prognosis of neonatal necrotizing enterocolitis[J]. Pediatrics, 2005, 116(5): 1064-1069.

[9]Kenton AB, O′Donovan D, Cass DL, Helmrath MA, Smith EO, Fernandes CJ, et al. Severe thrombocytopenia predicts outcome in neonates with necrotizing enterocolitis[J]. J Perinatol, 2005, 25(1): 14-20.

[10]Roy A, Tayeb M, Khogeer SS, Al-Salem AH. Predictors of gangrenous necrotizing enterocolitis and extent of disease. Early laparotomy versus peritoneal drainage[J]. Saudi Med J, 2005, 26(3): 447-452.

[11]Kulkarni A, Vigneswaran R. Necrotizing enterocolitis[J]. Indian J Pediatr, 2001, 68(9): 847-853.

[12]林慧佳,施丽萍,罗芳,鲍毓,马晓路.腹部X线量表在新生儿坏死性小肠结肠炎中的应用价值[J].中国当代儿科杂志,2012,14(2):97-100.

[13]Sharma R, Tepas JJ 3rd, Hudak ML, Wludyka PS, Mollitt DL, Garrison RD, et al. Portal venous gas and surgical outcome of neonatal necrotizing enterocolitis[J]. J Pediatr Surg, 2005, 40(2): 371-376.

[14]Clark RH, Gordon P, Walker WM, Laughon M, Smith PB, Spitzer AR. Characteristics of patients who die of necrotizing enterocolitis[J]. J Perinatol, 2012, 32(3): 199-204.

[15]Parikh M, Samujh R, Kanojia RP, Rao KL. Decision-making in surgical neonatal necrotizing enterocolitis[J]. J Indian Assoc Pediatr Surg, 2009, 14(3): 102-107.

[16]Aguilar Cuesta R, Barrena Delfa S, Hernández Oliveros F, Lassaletta Garbayo L, Tovar Larrucea JA. When is it best to perform enterostomy closure in premature infants with necrotizing enterocolitis? [J]. Cir Pediatr, 2011, 24(2): 109-111.
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