新生儿坏死性小肠结肠炎76例高危因素分析

Risk factors for neonatal necrotizing enterocolitis: An analysis of 76 cases

目的探讨围生期因素、喂养方式、服用益生菌、发病前合并疾病及发病前接受机械通气等对新生儿坏死性小肠结肠炎(NEC)发病的影响,旨在提供NEC发生的高危因素。方法选取2011年1月至2016年1月于中国医科大学附属盛京医院第一新生儿病房住院治疗的76例NEC患儿为病例组,并随机选取同期住院的80例非NEC患儿为对照组。回顾性分析患儿的临床资料,包括新生儿一般情况、围生期情况、喂养方式、口服益生菌情况、发病前合并其他疾病情况及接受机械通气等19个项目,应用SPSS软件进行单因素及多因素分析。结果单因素分析结果显示,病例组合并窒息、败血症、低血糖以及接受机械通气的比例显著高于对照组,口服益生菌的比例显著低于对照组,差异具有统计学意义(P<0.05)。Logistic多元回归分析结果显示,败血症(OR=6.531)、低血糖(OR=2.785)、机械通气(OR=3.448)为NEC发病的危险因素,口服益生菌为NEC的保护因素(OR=0.417)。结论败血症、低血糖及机械通气为NEC发病的危险因素,口服益生菌为NEC的保护因素。临床上应合理分析这些影响因素,早期预防及干预NEC,以改善患儿预后。

Objective To analyze the influence of perinatal period factors, feeding strategies,probiotics usage,compli- cations and mechanical ventilation before the onset of the disease on neonatal necrotizing enterocolitis （NEC）, in order to explore the risk factors for NEC. Methods Totally 76 infants with NEC were classified as the case group,who were hos- pitalized in the First Neonatal Department of Shengjing Hospital of China Medical University from January 2011 to Janu- ary 2016; 80 infants without NEC who were admitted at the same time were randomly selected as the control group. A ret- rospective analysis was performed on the clinical data of these patients, including general conditions of newborns, perina- tal period factors, feeding strategies, probiotics usage, complications and mechanical ventilation before the development of NEC. Single and multiple factor analysis was performed on 19 items using the SPSS analysis software. Results Single factor analysis revealed that the incidence of asphyxia, sepsis, hypoglycemia and mechanical ventilation was higher, while the incidence of oral probiotics usage was lower in the case group than the control group, with statisti- cally significant difference （P 〈 0.05 ）. According to the logistic multivariate regression analysis, sepsis （ OR = 6.531 ）, hy- poglycemia （OR = 2.785） and mechanical ventilation （OR = 3.448 ） were risk factors of NEC, while oral probiotics usage was protective factor of NEC （OR = 0.417）. Conclusion Sepsis, hypoglycemia and mechanical ventilation are risk factors of NEC, and oral probiotics usage is protective factor of NEC. We should pay attention to the prevention and interven- tion of NEC by reasonably analyzing these factors, in order to improve the prognosis of these children.