新生儿坏死性小肠结肠炎外科干预早期指征的探讨

Study on Early Indications of Surgical Intervention of Neonatal Necrotizing Enterocolitis(NEC)

目的探讨新生儿坏死性小肠结肠炎(NEC)外科干预的早期指征。方法随机收集2012年1月—2014年12月在该院收治的40例NEC患者进行研究,并对患者的病例资料进行分析,根据是否需要接受手术分为保守治疗组(26例)与手术组(14例),对比临床早期表现及辅助检查等的差异。结果需手术组在NEC早期出现肉眼血便、腹壁红肿、触痛,机械通气,X线表现肠襻固定、梗阻、肠壁间积气或气腹,病原学检出阳性的例数高于保守治疗组(P<0.05)。结论 NEC需要接受外科干预的早期指征是综合性的,临床应重视疾病早期症状及检查。

Objective To study the early indications of surgical intervention of neonatal necrotizing enterocolitis （NEC）. Methods 40 cases of patients with NEC treated in our hospital from January 2012 to December 2014 were collected and the case data of the patients were analyzed, they were divided into conservative treatment group （26 eases） and operation group （14 cases） according to whether the operation is needed or not, the differences in early clinical manifestation and accessory examination were compared. Results Gross blood stool, abdominal swelling, tenderness and mechanical ventilation occurred in early in NEC in the operation group, the X-ray manifestations were intestinal obstruction, intestinal loop fixation, intra- mural pneumatosis or pneumoperitoneum, the number of positive cases by the pathogen detection was higher than that in the conservative treatment group （P〈0.05）. Conclusion The early indications of NEC needing to receive surgical intervention is comprehensive, it is supposed to pay attention to early symptoms and examination of disease in clinic.