晚期新生儿单纯血便65例临床分析

Clinical analysis of 65 cases of simple bloody stool in the late neonatal

目的探讨住院晚期新生儿单纯性血便的临床相关因素、预防和治疗。方法对本院2014年9月至2016年9月住院晚期新生儿65例单纯大便出血的临床资料进行回顾性分析。结果出现单纯性血便的病种有新生儿高胆红素血症、新生儿肺炎、新生儿湿肺、新生儿窒息、早产儿、新生儿胃肠不耐受及外科疾病等；65例单纯性血便患者中以新生儿高胆红素血症为主（ 49.25%），而新生儿胃肠不耐受血便发生率（21.05%）相对增高（P〈0.01）；血便发病率：纯母乳喂养组（3.22%）与非纯母乳喂养组（0.44%）比较，差异有统计学意义（P〈0.01），部分母乳喂养（0.43%）、人工喂养组（0.49%）发生率比较差异无统计学意义（P〉0.05）。结论血便是新生儿期常见病症，晚期新生儿血便引发原因可能与新生儿凝血功能低下，疾病因素影响及喂养因素相关，除外科因素外可以通过补充维生素K1、调节胃肠菌群及保护肠道黏膜等控制，大部分预后良好。

Objective To explore the clinical relevant factors, prevention, and treatment of simple bloody stool in the late neonatal. Method From September, 2014 to September, 2016 the clinical data of 65 cases of simple bloody stool in the late neonatal treated at our hospital were retrospectively analyzed. Results Simple bloody stool could appear in the infants with hyperbilirubinemia, pneumonia, wet lung of newborn, neonatal asphyxia, preterm, nenatal gastrointestinal intolerance, and surgical diseases. Of the 65 infants with simple bloody stool, the patients with hyperbilirubinemia accounted for the main proportion （49.25%）; the incidenceof simple bloody stool were relatively higher in infants with gastrointestinal intolerance （ 21.05%, P 〈 0.01）. The incidence was 3.22% in the exclusive breast feeding group and 0.44% in the non-exclusive breast feeding group, with a statistical difference（P 〈 0.01）; the incidence was 0.43% in the incomplete breast feeding group and 0.49% in the formula feeding group, with no statistical difference（P 〉 0.05）. Conclusions Neonatal bloody stool is common during neonatal period. Its cause maybe low blood coagulation function, disease, and feeding factors. It could be controlled taking vitamin K1, adjusting intestinal flora, and protecting intestinal mueosa. Most have good prognosis.