新生儿坏死性小肠结肠炎伴发肠穿孔危险因素的回顾性研究

Retrospective study on risk factors for concurrent intestinal perforation in neonates with necrotizing enterocolitis

目的:探讨新生儿坏死性小肠结肠炎(NEC)伴发肠穿孔的危险因素。方法:回顾性分析55例NEC伴发肠穿孔患儿(NEC伴发肠穿孔组)的临床资料,并随机选取110例同期收治的NEC未伴发肠穿孔患儿为对照组,采用单因素和多因素Logistic回归分析,总结NEC伴发肠穿孔的危险因素。结果:NEC并发败血症(OR=2.557)、凝血功能障碍(OR=4.075)、低钾血症(OR=5.180)是肠穿孔的独立危险因素(P<0.05),而高胎龄(OR=0.884)为保护因素(P<0.05)。上述3个独立危险因素联合对NEC伴发肠穿孔的预测价值最高,ROC曲线下面积为0.875,特异性和灵敏性分别为79.2%、81.8%。结论:NEC伴发败血症、凝血功能障碍、低钾血症是NEC伴发肠穿孔的独立危险因素。三者联合对NEC伴发肠穿孔有较高预测价值。

Objective:To explore the risk factors for necrotizing enterocolitis(NEC)with intestinal perforation in neonates.Methods:The clinical data of 55 NEC patients with intestinal perforation(Group 1)were retrospectively analyzed,and 110 children diagnosed as NEC without intestinal perforation(Group 2)admitted at the same time were randomly selected as the control group.Univariate and multivariate logistic regression analysis methods were used to summarize the risk factors of NEC with intestinal perforation.Results:NEC complicated with sepsis(OR=2.557),coagulation dysfunction(OR=4.075)and hypokalemia(OR=5.180)were independent risk factors for concurrent intestinal perforation(P<0.05),and high gestational age(OR=0.884)was the protective factor(P<0.05).The combination of the three independent risk factors mentioned above has the highest predictive value for NEC with intestinal perforation.The area under the curve of ROC was 0.875,and the specificity and sensitivity were 79.2%and 81.8%,respectively.Conclusion:NEC complicated with sepsis,coagulation dysfunction and hypokalemia are independent risk factors for NEC with intestinal perforation.The combination of three independent risk factors has a high predictive value for NEC with intestinal perforation.