【摘要】：目的：探討早產(chǎn)兒壞死性小腸結(jié)腸炎的臨床特征及影響因素,進行必要的干預,減少暴露機會,降低NEC的發(fā)病率。方法：依照納入及排除標準選擇2010年1月1日-2013年06月30日入住新疆醫(yī)科大學第一附屬醫(yī)院新生兒科1327例早產(chǎn)兒及其中發(fā)生NEC的87例患兒進行回顧性病例對照研究。對其臨床特征進行統(tǒng)計描述、推斷及Logistic回歸分析其影響因素。結(jié)果：①早產(chǎn)兒NEC發(fā)病率為6.56%,其中極低出生體重兒發(fā)病率高達19%。臨床表現(xiàn)以胃潴留、腹脹及腸鳴音減弱為主要表現(xiàn)。②與未發(fā)生NEC的早產(chǎn)兒相比,早產(chǎn)兒壞死性小腸結(jié)腸炎在胎齡(t=-2.353,P0.05)、出生體重(t=-3.398,P0.05)間分布有統(tǒng)計學差異,而在性別(x2=1.269,P=0.26)、民族(x2=3.795,P=0.284)間分布無統(tǒng)計學差異。③早產(chǎn)兒壞死性小腸結(jié)腸炎的嚴重程度(不同分期)在血小板降低(x2=9.419,P0.05)、CRP升高(x2=5.060,P0.05)、輸血(x2=5.78,P0.05)間分布的差異有統(tǒng)計學意義,而在胎齡、出生體重間差異無統(tǒng)計學意義。④二分類Logistic回歸分析顯示出生體重(β=-0.001,P0.05,Exp(β)=0.999)、喂養(yǎng)方式(β=-9.190,P0.05,Exp(β)=0.000)、孕母疾病(β=3.237,P0.05,Exp(β)=25.469)、貧血(β=3.780,P0.05,Exp(β)=43.814)及輸血(β=3.328,P0.05,Exp(β)=27.894)與早產(chǎn)兒壞死性小腸結(jié)腸炎的發(fā)生有關(guān)。結(jié)論：早產(chǎn)兒壞死性小腸結(jié)腸炎是臨床上新生兒重癥監(jiān)護室內(nèi)常見的胃腸道疾病,且出生體重越低、胎齡越小,發(fā)病率越高。其中出生體重、喂養(yǎng)方式(母乳喂養(yǎng))為其保護性因素,而孕母疾病、貧血、輸血則為其危險性因素,需積極預防及正確干預。
[Abstract]:Objective: to investigate the clinical characteristics and influencing factors of necrotizing enterocolitis in premature infants, and to make necessary intervention to reduce the chance of exposure and the incidence of NEC. Methods: according to the inclusion and exclusion criteria, a retrospective case-control study was conducted in 1327 premature infants and 87 children with NECs in the first affiliated Hospital of Xinjiang Medical University from January 1, 2010 to June 30, 2013. The clinical features were statistically described, inferred and logistic regression analysis were used to analyze the influencing factors. Results the incidence of NEC in premature infants was 6.56 and the incidence of very low birth weight infants was as high as 19. The main clinical manifestations were gastric retention, abdominal distension and decreased bowel tone. 2. Compared with premature infants without NEC, necrotizing enterocolitis of preterm infants was significantly different in gestational age (t = 2.353), birth weight (t = 3.398p. 05), and no significant difference was found in the distribution of necrotizing enterocolitis between preterm infants and preterm infants. However, there was no significant difference in the distribution of serum CRP between the two ethnic groups (x2P 1.269, P < 0.26) and ethnic groups (x2n 3.795). 3 the severity of necrotizing enterocolitis of premature infants (different stages) was significantly higher than that of blood transfusion (x2P 5.060, P 0.05), but at gestational age, there was no significant difference in the distribution of CRP in the patients with necrotizing enterocolitis (x2P 9.419 P 0.05) and blood transfusion (x2P 5.788 P 0.05), but in the gestational age, there was no significant difference in the distribution of CRP between the two groups. Logistic regression analysis showed that birth weight (尾 -0.001) P0.05Exp (尾) 0.999, feeding pattern (尾 -9.190 P0.05Exp (尾) 0.000), maternal diseases (尾 -3.237P0.05Exp (尾) 25.469), anemia (尾 3.780P0.05Exp (尾) 43.814) and blood transfusion (尾 3.328P0.05Exp (尾) 27.894) were associated with the development of necrotizing enteritis in preterm infants. Conclusion: necrotizing enterocolitis of premature infants is a common gastrointestinal disease in neonatal intensive care unit. The lower the birth weight and the smaller the gestational age, the higher the incidence. Birth weight and feeding mode (breast-feeding) are the protective factors, while maternal diseases, anemia and blood transfusion are the risk factors.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R722.6

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