新生儿坏死性小肠结肠炎病情进展的影响因素分析

Analysis of influencing factors on the progression of neonatal necrotizing enterocolitis

目的探讨影响新生儿坏死性小肠结肠炎(NEC)病情进展的相关因素。方法选择2015年10月至2017年10月在我院确诊的102例坏死性小肠结肠炎患儿的临床资料,按照Bell分期将其分为Ⅰ期组(62例)、Ⅱ期/Ⅲ期组(40例)。对各项可能引起NEC病情进展的相关因素进行单因素和多因素Logistic回归分析。结果单因素分析结果显示,贫血、胎龄小于37周、出生体重小于2.5 kg、合并呼吸衰竭、合并心力衰竭、母乳喂养、发病前使用益生菌及合并消化道畸形是影响NEC病情进展的相关因素(P<0.05)。多因素分析显示,贫血、胎龄、出生体重、合并呼吸衰竭、合并心力衰竭、母乳喂养、发病前口服益生菌、合并消化道畸形均与NEC的疾病进展存在相关性(P<0.05),其中贫血、胎龄、出生体重、合并呼吸衰竭、合并心力衰竭及合并消化道畸形为影响NEC进展的独立危险因素,而母乳喂养、发病前口服益生菌则为NEC进展的保护因素(P<0.05)。结论 NEC的恶化与早产、体重、合并呼吸衰竭、合并心力衰竭、母乳喂养等因素有关,采取母乳喂养并口服益生菌能够减轻NEC的严重程度。

Objective To investigate the influence factors on the progression of neonatal necrotizing enterocolitis.Methods The clinical data of 102 children diagnosed as neonatal necrotizing enterocolitis in our hospital from October2015 to October 2017 were selected and divided into stageI group （62 cases） and stage II/III group （40 cases） accordingto Bell stage. Single factor and multivariate Logistic regression analysis was performed on the related factors that maycause the progression of NEC. Results The univariate analysis showed that anemia, gestational age less than 37 weeks,birth weight less than 2.5 kg, combined with respiratory failure, heart failure, breast feeding, use of probiotics beforeonset and digestive tract malformation were the influence factors of the progression of NEC （P〈0.05）. The multivariateanalysis showed that anemia, gestational age, birth weight, combined with respiratory failure, heart failure, breast feeding,use of probiotics before onset and combined with digestive tract malformation were all associated with disease progressionin NEC（P〈0.05）. The anemia, gestational age, birth weight, combined with respiratory failure, heart failure and combinedwith digestive tract malformation were independent risk factors of the progression of NEC, while the breast feeding anduse of probiotics before onset were the protective factors of the progression of NEC（P〈0.05）. Conclusion The severity ofNEC is related to premature birth, body weight, respiratory failure, heart failure, breastfeeding, etc. Breastfeeding and oralprobiotics can reduce the severity of NEC.