新生儿坏死性小肠结肠炎的临床表现和辅助检查特征分析

Analysis of clinical manifestation and auxiliary examination features of neonatal necrotizing enterocolitis

目的：了解新生儿坏死性小肠结肠炎（NEC）临床表现与辅助检查特征。方法：分析2012年3月～2014年3月收治的40例NEC患儿的临床资料。结果：40例患儿平均胎龄为33．46±3．73周，平均体重2460．00±750．00g；2例胎膜早破，7例新生儿窒息；30例人工喂养，6例母乳喂养，4例未开奶；伴有呕吐、腹胀、便血等胃肠道症状，同时存在呼吸暂停、发热等全身非特异性表现，实验室检查提示属于非特异性；27例接受保守治疗，其中12例治疗24～48h无效后接受手术治疗，13例直接接受手术治疗，其中2例腹腔穿刺异常。8例消化道穿孔，3例弥漫性腹膜炎，共3例死亡。结论：新生儿NEC临床表现缺乏典型性。病情进展快，预后往往不佳，重视腹部X线检查及血小板计数、白细胞计数、C-反应蛋白白细胞计数等监测对改善NEC患儿预后具有重要价值。

Objective： to understand the neonatal necrotizing enterocolitis （NEC） clinical manifestation and auxiliary examination characteristic. Methods： Retrospective analysis of 40 cases of children with NEC in our hospital from 2012 March to 2014 March were analyzed. Results：40 patients the mean gestational age was 33.46 ＋ 3.73 weeks, the average weight of 2460 ＋ 750 g; 2 cases of premature rupture of membranes, neonatal asphyxia 7 cases; 30 cases of artificial feeding, 6 cases of breast feeding, 4 cases of raw milk; accompanied by vomiting, abdominal distension, bloody stool and other gastrointestinal symptoms, exist at the same time call the sNECtion performance of suspension, fever and other systemic nonspecific, laboratory examination prompts are nonspeeific; 27 cases received conservative treatment, including 12 cases of treatment of 24~48 h is invalid after surgery, 13 cases directly accepted surgical treatment, including 2 cases of abdominal puncture abnormality, 8 cases of digestive tract perforation, 3 cases of diffuse peritonitis, 3 cases occurred death. Conclusion： the clinical manifestations of neonatal NEC lack of representativeness, rapid progression of the disease, the prognosis is often poor, attach importance to abdominal X- ray examination and blood platelet count, white blood cell count, C- reactive protein, white blood cell count monitoring has important application value for improving the prognosis of NEC.