| 摘要: |
| 目的 探讨新生儿坏死性小肠结肠炎（NEC）不良预后的高危因素。方法 回顾性分析2017年1月至2018年12月我院收治的83例Bell Ⅱ期以上NEC新生儿的临床资料，按NEC预后将新生儿分为观察组（预后不良，需外科手术、放弃治疗或死亡）和对照组（治愈出院）。对两组NEC新生儿的一般资料、围生期因素、发病前喂养情况、治疗情况、发病时的实验室辅助检查和临床表现等进行单因素及多因素logistic回归分析。结果 83例NEC新生儿中观察组28例（33.7%）、对照组55例（66.3%）。观察组胎龄、出生体重、产前应用糖皮质激素占比、动脉导管未闭发生率、发病日龄、首次开奶时间、脐静脉置管占比、布洛芬使用占比、预防性抗生素使用占比及发病时白细胞计数、血小板计数、不成熟中性粒细胞/总中性粒细胞比值、降钙素原水平、血培养阳性占比、腹胀占比与对照组比较差异均有统计学意义（P均＜0.05）。多因素logistic回归分析结果显示胎龄增大（OR＝0.68）和发病时白细胞计数升高（OR＝0.81）为保护性因素，发病时降钙素原＞10 ng/mL（OR＝7.32）为NEC预后不良的危险因素（P均＜0.05）。结论 胎龄增大、发病时白细胞计数升高为NEC预后不良的保护性因素，发病时降钙素原＞10 ng/mL为NEC预后不良的高危因素。 |
| 关键词: 早产儿 坏死性小肠结肠炎 预后 危险因素 |
| DOI：10.16781/j.CN31-2187/R.20200267 |
| 投稿时间：2020-03-03修订日期：2020-12-18 |
| 基金项目:重庆市妇幼保健院院级科研课题(2020YJQN01),重庆市妇幼科研培育项目(2021FY109). |
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| Risk factors for poor prognosis in newborns with neonatal necrotizing enterocolitis |
| WU Yan,GONG Hua*,ZHONG Xiao-yun,CHEN Wen,LIAO Ling-fan,ZHOU Li-gang,WEI Lian |
(Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing 401147, China
*Corresponding author) |
| Abstract: |
| Objective To explore the risk factors for poor prognosis of neonatal necrotizing enterocolitis (NEC).Methods The clinical data of 83 newborns with NEC (Bell stage>Ⅱ),who were treated in our hospital from Jan.2017 to Dec.2018,were analyzed retrospectively.According to the prognosis of NEC,the newborns were divided into observation group (with poor prognosis,requiring surgery,giving up treatment,or death) and control group (cured).The general data,perinatal factors,feeding before onset,treatment,laboratory auxiliary examination at onset and clinical manifestations of newborns in the 2 groups were analyzed by univariate and multivariate logistic regression analyses.Results Among the 83 NEC newborns,there were 28 cases (33.7%) in the observation group and 55 cases (66.3%) in the control group,with significant differences between the 2 groups in gestational age,birth weight,incidence of patent ductus arteriosus,time of NEC onset,first time of feeding,proportions of antenatal steroid administration,umbilical vein catheters,ibuprofen administration and prophylactic antibiotics administration,as well as white blood cell (WBC) count,platelet count,immature/total neutrophil ratio,procalcitonin level,proportion of positive blood culture and proportion of abdominal distention at onset (all P<0.05).Multivariate logistic regression analysis showed that increased gestational age (odds ratio[OR]=0.68) and WBC count at onset (OR=0.81) were protective factors,and procalcitonin>10 ng/mL at onset (OR=7.32) was a risk factor for poor prognosis of NEC (all P<0.05).Conclusion The increased gestational age and WBC count at onset are protective factors for the poor prognosis of NEC,and procalcitonin >10 ng/mL at onset is a risk factor for the poor prognosis of NEC. |
| Key words: premature infants necrotizing enterocolitis prognosis risk factors |
