低出生体质量儿坏死性小肠结肠炎的影响因素及预后分析

Risk Factors and Prognosis of Necrotizing Enterocolitis in Low Birth Weight Infants

目的探讨低出生体质量儿坏死性小肠结肠炎(NEC)的影响因素及预后分析。方法选取我院于2016年11月至2018年12月收治的90例NEC低出生体质量儿作为观察组,另按照住院号随机选取同期住院的非NEC低出生体质量儿181例作为对照组。收集两组患儿临床资料,并对相关因素进行单因素及Logistic回归分析。结果经单因素分析,两组患儿出生体质量、性别比例差异均无统计学意义(P均>0.05);观察组患儿胎龄、母乳喂养比例均低于对照组(P均<0.05);观察组患儿喂养不当、败血症、产时窒息、输血比例均高于对照组(P均<0.05)。经多因素Logistic回归分析,喂养不当、败血症、母乳喂养、产时窒息、输血均是低出生体质量儿NEC发生的影响因素,其中母乳喂养是保护因素,其余均是危险因素。随访结果显示,观察组病死率高于对照组(P<0.05)。结论低出生体质量儿发生NEC的影响较多,应尽可能规避或及时治疗,采取综合预防措施,降低低出生体质量儿NEC发生率,并改善其预后质量。

Objective To investigate the risk factors and prognosis of necrotizing enterocolitis in low birth weight infants.Methods Ninety cases of low birth weight neonates with NEC admitted to our hospital from November 2016 to December 2018 were selected as observation group,and 181 cases of non-NEC low birth weight neonates in the same period were randomly selected as control group according to the number of hospitalization.The clinical data of the two groups were collected,and the related factors were analyzed by single factor and multi-factor analysis.Results Univariate analysis showed that there was no significant difference in birth weight and sex ratio between the two groups(P all>0.05).The gestational age of the observation group was significantly lower than that of the control group(P all<0.05).The improper feeding,sepsis,asphyxia during delivery and transfusion ratio of the observation group were significantly higher than those of the control group,and the breastfeeding ratio of the observation group was significantly lower than that of the control group(P all<0.05).Multivariate logistic regression analysis showed that inappropriate feeding,sepsis,breastfeeding,asphyxia during delivery and blood transfusion were closely related to the occurrence of NEC in low birth weight infants.Breastfeeding was a protective factor,while the rest were risk factors.According to the follow-up results,the mortality rate of the observation group was significantly higher than that of the control group(P all<0.05).Conclusion There are many risk factors for NEC in low birth weight infants.It is necessary to avoid or treat NEC as soon as possible and take comprehensive preventive measure to reduce the incidence of NEC in low birth weight infants and improve the prognosis quality.