136例新生儿坏死性小肠结肠炎临床分析

Multiple risk factors analysis of inducement and prognosis of neonatal necrotizing enterocolitis

目的 探讨新生儿坏死性小肠结肠炎 (neonatalnecrotizingenterocolitis,NEC )发病及预后的危险因素。方法 回顾性分析 1 36例NEC的诱因、合并症、并发症及治疗结局等多项指标。结果 窒息、肺炎、体温不升、硬肿症等为NEC发病主要诱因。死亡组与治愈组相比NEC患儿合并或并发败血症、硬肿症、呼吸衰竭、全腹膜炎、低钠血症、代谢性酸中毒、肺出血、全心衰、肾功能衰竭、休克、中毒性脑病之合并率或并发率明显较高 (P <0 .0 5 )。NEC患儿同时合并上述 0、1、2、3、4项危险因素时 ,其病死率分别为 3.9% ,2 6 % ,33.3% ,80 %和 5 0 % ,合并 5项或 5项以上时病死率为 1 0 0 % ,治愈组平均住院天数为 (5 .2± 6 .9)d ,死亡组为 (4 .9±6 .2 )d(t=7.90 3,P <0 .0 5 )。结论 应避免NEC发病的各种危险因素 ,积极防治NEC的各种合并症及并发症 。

Objective To explore the risk factors of inducement and prognosis of neonatal necrotizing enterocolitis (NEC).Methods One hundred and thirty six cases of NEC from June 1970 to March 2003 were analyzed retrospectively.Results The inducement risk factors of NEC include: asphyxia,pneumonia,hepothermia and sclerema neonatorum.The death group infants were more combination or complicated syndrome than the cured group in the sepsis,sclerema neonatorum,respiratory failure,intracranial hemorrhage,peritonitis,hyponatremia,matebolic acidosis,pulmonary hemorrhage,heart failure,kidney failure,shock and toxic encephalopathy( P <0.05).NEC infants combined with 0,1,2,3,4,5 and more than 5 these risk factors,their mortality were 3.9%,26%,33.33%,80%,50% and 100% respectively.The duration of hospitalizing in cure group was 15.2±6.9 days,and 4.9±6.2 days in the death group( t =7.903, P <0.05).Conclusion Avoiding multiple risk factors of episode and treating actively the combination or complication syndrome can decrease the mortality of NEC.