發(fā)布時間：2018-03-30 16:13

  本文選題：新生兒壞死性小腸結(jié)腸炎　切入點：危險因素　出處：《重慶醫(yī)科大學(xué)學(xué)報》2017年03期

【摘要】：目的:探討新生兒壞死性小腸結(jié)腸炎(neonatal necrotizing enterocolitis,NEC)的發(fā)病危險因素以及外科治療預(yù)后的影響因素。方法:對2005年6月至2015年12月我院接收的59例新生兒NEC患兒以及80例非腸道疾病住院新生兒患者的臨床資料進(jìn)行回顧性分析,對影響NEC發(fā)病的危險因素進(jìn)行單因素及多因素logistic回歸分析;同時對59例NEC患兒根據(jù)預(yù)后情況分成2組,即存活組與死亡組,對影響NEC患兒外科治療預(yù)后的因素進(jìn)行分析。結(jié)果:NEC發(fā)病單因素分析結(jié)果顯示,新生兒NEC的發(fā)病與產(chǎn)時窒息、產(chǎn)前使用糖皮質(zhì)激素、感染肺炎、合并呼吸衰竭、感染性休克、彌漫性血管內(nèi)凝血、發(fā)病前輸注紅細(xì)胞、臍靜脈置管、出生后吸氧、低鈣血癥、低鈉血癥、敗血癥、口服益生菌、發(fā)病前喂養(yǎng)有關(guān);NEC發(fā)病多因素logistic回歸分析結(jié)果顯示,感染肺炎、敗血癥、臍靜脈置管是誘發(fā)NEC的高危因素(OR=2.976~5.352,P0.05),產(chǎn)前使用糖皮質(zhì)激素、發(fā)病前喂養(yǎng)、益生菌是NEC的獨立保護(hù)因素(OR=0.435~0.605,P0.05);外科治療預(yù)后因素分析結(jié)果顯示,NEC患兒出現(xiàn)循環(huán)衰竭、≥3處穿孔、感染性休克、代謝性酸中毒、低體質(zhì)量,預(yù)后越差(P0.05)。結(jié)論:NEC的發(fā)病與多種因素密切相關(guān),通過控制NEC的高危因素、增加保護(hù)因素可減少NEC的發(fā)病;影響NEC外科治療預(yù)后的因素同樣眾多,如循環(huán)衰竭、≥3處穿孔、低體重兒等,對于易誘發(fā)不良預(yù)后的因素應(yīng)給予積極的防治措施,以改善患兒預(yù)后,提高其存活率。
[Abstract]:Objective: to investigate the risk factors of neonatal necrotizing enterocolitis (NEC) and the prognostic factors of surgical treatment.Methods: the clinical data of 59 neonates with NEC and 80 hospitalized neonates with non-intestinal diseases from June 2005 to December 2015 were retrospectively analyzed.Univariate and multivariate logistic regression analysis was used to analyze the risk factors affecting the pathogenesis of NEC and 59 cases of NEC were divided into two groups according to their prognosis: survival group and death group. The factors influencing the prognosis of NEC patients were analyzed.Results the univariate analysis of NEC showed that neonatal NEC was asphyxiated during labor, prepartum use of glucocorticoid, infection with pneumonia, respiratory failure, septic shock, diffuse intravascular coagulation, red blood cell transfusion before onset.Umbilical vein catheterization, postnatal oxygen inhalation, hypocalcemia, hyponatremia, septicemia, oral probiotics, feeding before onset related to the incidence of NEC logistic regression analysis showed that infection pneumonia, septicemia,Umbilical vein catheterization is a high risk factor for inducing NEC. The risk factor is ORG 2.976 ~ 5.352% P0.05A, pre- partum use of glucocorticoid, feeding before onset, probiotics is the independent protective factor of NEC (Orr 0.4350.605) P0.05.The prognostic factor analysis of surgical treatment showed that there were circulatory failure and more than 3 perforations in children with NEC.Septic shock, metabolic acidosis, low body mass and worse prognosis (P 0.05).Conclusion the incidence of NEC is closely related to many factors. By controlling the high risk factors of NEC, increasing the protective factors can reduce the incidence of NEC, and there are many factors affecting the prognosis of NEC surgical treatment, such as circulatory failure, 鈮，

本文編號：1686650