足月儿与早产儿坏死性小肠结肠炎临床特征及危险因素分析

Clinical Characteristics and Risk Factors of Necrotizing Enterocolitis in Term Infants and Preterm Infants

目的:探讨早产儿与足月儿坏死性小肠结肠炎(NEC)的临床特征、危险因素及预后。方法:采用回顾性研究方法,收集2016-2018年在重庆医科大学附属儿童医院诊断为新生儿NEC的325例住院患儿的病历资料,根据胎龄分为足月儿与早产儿,分别从发病日龄、临床表现、主要合并症等方面分析。结果:足月儿组多表现为便血、呕吐(P<0.05),早产儿组多表现为腹胀、肠鸣音减弱等(P<0.05);早产儿组NEC并发症发生率高于足月儿组(P<0.05);早产儿组与足月儿组预后不良比较,差异有统计学意义(P<0.01)。新生儿败血症、休克、先天性心脏病3个变量是影响NEC临床结局的独立危险因素(P<0.05)。结论:注意防治各胎龄段新生儿高危因素,密切观察临床表现、辅助检查,预防及减少并发症等有助于减少NEC的发生及改善预后。

Objective:To probe into the clinical features,risk factors and prognosis of necrotizing enterocolitis(NEC)in preterm infants and term infants.Methods:Totally 325 neonates diagnosed with NEC in the Children’s Hospital of Chongqing Medical University from 2016 to 2018 were retrospectively analyzed with the clinical data,clinical manifestations and major complications,and all children were divided into the term infant group and preterm infant group according to the gestational age.Results:Blood stool and vomiting were the most common clinical manifestations of the term infants(P<0.05),abdominal distension and hypoactive bowel sounds were the most common clinical manifestations of the preterm infants(P<0.05).The incidence of NEC complications in the preterm infant group was significantly higher than that in the term infant group(P<0.05).There was statistically significant difference between the term infant group and the the preterm infant group in poor prognosis(P<0.01).Neonatal sepsis,neonatal shock and congenital heart disease were independent risk factors affecting the clinical outcome of NEC(P<0.05).Conclusion:Paying attention to the prevention and treatment of high risk factors of all gestational age groups of neonates,closely observing clinical manifestations,auxiliary examination,prevention and reduction of complications are helpful to reduce the incidence of NEC and improve the prognosis.