坏死性小肠结肠炎早产儿病因及微生态制剂预防作用

Relative Factors of Neonatal Necrotizing Enterocolitis and Preventive Effect of Microeco-Preparation

目的探讨新生儿坏死性小肠结肠炎(NEC)病因及应用微生态制剂(培菲康)预防早产儿NEC的有效性及对体质量的影响。方法早产儿524例,随机分为预防组276例与非预防组248例。预防组予培菲康口服,0.5包/次,2次/d;非预防组仅予原发病治疗。观察二组NEC的发生情况及体质量变化。确诊NEC20例患儿为病例组,非NEC80例早产儿为对照组,对二组进行对照研究。结果预防组发生NEC5例,每日体质量增加(8.114±8.137)g;非预防组发生NEC17例,每日体质量增加(6.595±5.337)g。二组NEC发生率比较有显著差异(χ2=7.57P<0.01);二组每日体质量增加量比较有显著差异(t=2.497P<0.05)。Logistic多元回归分析提示:胎龄、HIE、败血症及病情危重症程度是NEC发生的危险因素,应用微生态制剂及免疫球蛋白(IVIG)是保护因素。结论避免NEC的危险因素,应用IVIG和微生态制剂能减少早产儿NEC的发生和促进体质量增长。

Objective To explore the risk factors of neonatal necrotizing enterocolitis（NEC）and assess the effect of prophylactic use of probiotics（Bifico）in prevention of NEC and observe changes of weight.Methods Five hundred and twenty-four cases of prematures who were inpatients were divided into 2 groups randomly（prevention group,n=276,no-prevention group,n=248）and the morbidity of NEC and the increase of eight during hospitalization were observed.A case-control study and conditional Logistic regression model multifactorial analysis were made to 20 cases NEC neonates and 80 cases non-NEC neonates.Results The prevention group（276 cases）had 5 cases of NEC and the average weight increase was（8.114±8.137）g/d,the no-prevention group 248 cases had 17 cases of NEC,and the average weight increase was（6.595±5.337）g/d.The occure rate of NEC in prevention group was significantly lower than that of no-prevention group（χ^2=5.57 P〈0.01）.And there was significant difference of weight inerease between 2 groups（t=2.497 P〈0.05）.The risk factors of NEC were gestation age,HIE,septicemia,and serious illness.Protective factors were application of probiotics and intravenous immune globulin（IVIG）.Conclusions To avoid the risk factors for NEC and use of probiotics and IVIG in neonatal in hospital can prevent the occurrence of NEC,and increase weight of hospitalized neonates.