【摘要】：目的探討新生兒壞死性小腸結(jié)腸炎的臨床特點、診療、預后及危險因素,為臨床診治及改善預后提供依據(jù)。 方法對廣西醫(yī)科大學第一附屬醫(yī)院新生兒科2003年1月-2012年12月收治的97例新生兒NEC患兒進行回顧性分析。分析NEC患兒發(fā)生率及臨床資料。根據(jù)轉(zhuǎn)歸不同分成治愈組及預后不良組,比較兩組與預后相關(guān)因素的差異,尋找影響預后的因素。采用SPSS13.0統(tǒng)計軟件對數(shù)據(jù)進行處理,兩樣本率的比較使用卡方檢驗、確切概率法,以及多因素Logistic回歸分析。 結(jié)果97例NEC10年發(fā)生率為1.1%,2003-2007年5年發(fā)生率為1.6%,2008-2012年5年發(fā)生率為0.8%。前后5年的發(fā)生率比較有統(tǒng)計學差異。早產(chǎn)兒78例(80.4%),足月兒19例(19.6%),平均胎齡(33.0±4.94)周,平均出生體重2131±723.54g。治愈79例,預后不良18例。NEC Ⅰ期20例,治愈率95.0%,Ⅱ期55例,治愈率72.7%,Ⅲ期22例,治愈率59.0%。單因素分析：早產(chǎn)、低出生體重、人工喂養(yǎng)、敗血癥、肺炎、呼吸暫停、硬腫癥、休克、腹膜炎、高血糖、代謝性酸中毒、DIC、腸穿孔、腸道畸形、腹部X線異常、Bell分期與NEC預后不良有關(guān)。進行多因素分析,提示早產(chǎn)、敗血癥、代謝性酸中毒是影響預后的高危因素。 結(jié)論(1)NEC患兒以早產(chǎn)兒,低出生體重兒,小于胎齡兒,人工喂養(yǎng)兒,增加奶量速度20ml/kg.d的新生兒多見。(2)NEC的預后與早產(chǎn)、低出生體重、人工喂養(yǎng)、敗血癥、肺炎、呼吸暫停、硬腫癥、休克、腹膜炎、高血糖、代謝性酸中毒、DIC、腸穿孔、腸道畸形、腹部X線異常有關(guān)。(3) Bell分期越差,預后越差。(4)早產(chǎn)、敗血癥、代謝性酸中毒是影響預后的重要因素。
[Abstract]:Objective to investigate the clinical features, diagnosis and treatment, prognosis and risk factors of neonatal necrotizing enterocolitis. Methods 97 neonates with NEC admitted from January 2003 to December 2012 in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The incidence and clinical data of children with NEC were analyzed. According to the outcome, the patients were divided into two groups: the cured group and the poor prognosis group. The difference between the two groups and the prognostic factors was compared, and the factors affecting the prognosis were found. The data were processed by SPSS13.0 statistical software. The comparison of the two sample rates was carried out by chi-square test, exact probability method and multivariate Logistic regression analysis. Results the annual incidence rate of 97 cases of NEC10 was 1.1%. The incidence rate of 5 years from 2003 to 2007 was 1.6 years, and the incidence rate of 2008 to 2012 was 0.8 years. There was a statistical difference in the incidence between the two groups in 5 years. There were 78 premature infants (80.4%) and 19 term infants (19.6%). The average gestational age was (33.0 鹵4.94) weeks and the average birth weight was 2131 鹵723.54 g. 79 cases were cured and 18 cases had poor prognosis. The cure rate was 95.0 in NEC 鈪，

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