早产新生儿坏死性小肠结肠炎危险因素分析.docVIP

早产新生儿坏死性小肠结肠炎危险因素分析 　　【关键词】 坏死性小肠结肠炎;新生儿;早产儿;危险因素 　　中图分类号：R722 文献标识码：A DOI：10.3969/j.issn.1003-1383.2018.01.021 　　Analysis of risk factors of necrotizing enterocolitis in preterm neonates 　　LU Hao，ZHOU Haiyun，HE Yubin 　　【Abstract】 Objective To investigate the risk factors of neonatal necrotizing enterocolitis（NEC）. 　　Methods 50 premature infants with preterm NEC were selected as observation group，and another 50 premature infants without preterm NEC in the same period were selected as control group.General data，perinatal data，combined diseases，and the main factors of NEC in premature newborns were retrospectively analyzed between the two groups. 　　Results Difference of the history of asphyxia，congenital heart disease，septicaemia and ischemic bowel disease between the observation group and the control group was statistically significant（Plt;0.05）.Univariate and multivariate analysis showed that the risk factors for NEC in premature neonates were mainly septicemia，congenital heart disease，ischemic bowel disease，asphyxia and low gestational age. 　　Conclusion Many factors affect NEC in premature infants，and septicemia，congenital heart disease，ischemic bowel disease，asphyxia and gestational age are risk factors.So preterm infants with these risk factors should be payed high attention to alert the occurrence of this disease. 　　【Key words】 NEC;neonate;premature infant;risk factors 　　新生?夯邓佬孕〕?结肠炎（NEC）是早产儿中常见的胃肠道急症，主要临床症状为便血、腹泻、呕吐、腹胀，同时伴有体温变化、心动过缓、休克等症状，严重的患儿可出现肠坏死、肠穿孔、多器官功能衰竭、弥散性血管内凝血等，甚至死亡，腹部平片可见患儿肠管扩张、梗阻、积气或静脉积气等[1～3]。目前其具体影响因素和发病机制仍不明确，本研究对比非NEC患儿及早产NEC住院新生儿临床资料，分析影响早产儿NEC的主要因素，并讨论其发病机制，报道如下。 1 资料与方法 　　1.1 一般资料 　　2013年1月～2015年5月期间在我院选取50例确诊的坏死性小肠结肠炎早产新生儿归为观察组，根据住院号随机抽选同期住院的非坏死性小肠结肠炎新生儿为对照组（50例）。观察组纳入标准：胎龄lt;33周，根据《实用新生儿学》[4]Bell分期为Ⅱ期以上。对照组纳入标准[5]：非NEC，已经治愈的患儿，胎龄为25～33周。两组排除标准：遗传性代谢性疾病、消化道先天性畸形。 　　1.2 研究方法 　　回顾性分析两组患儿临床资料，包括患儿一般资料：胎龄、出生体重、发病时间、性别等;孕母情况：产前抗生素使用情况、胎膜早破、高血压;出生情况：有无窒息（pHlt;7.0，Apgar评分lt;3分，多功能脏器损伤）;发病前伴发疾病情况：肺炎、高胆红素血症、败血症、肺炎、先天性心脏病（大室间隔缺损、大房