作　　者： (刘利）; (李秋宇）; (安瑶）; (冉亚林）; (李禄全）;

机构地区： 重庆医科大学附属儿童医院新生儿诊治中心、儿童发育疾病研究教育部重点实验室、儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,重庆400014

出　　处： 《重庆医科大学学报》 2017年第8期1006-1010,共5页

摘　　要： 目的:对比分析早产与足月新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)的临床特点。方法:回顾性分析338例NEC临床资料,比较患儿围产期相关信息、NEC诊断后并发症、治疗情况及预后危险因素。结果:早产组94例,足月组244例,早产组胎膜早破发生率高于足月组;早产组NEC诊断后并发败血症、呼吸衰竭高于足月组;早产组NEC诊断后多巴胺、IVIG使用率及输注红细胞高于足月组(均P<0.05)。logistic回归分析发现,影响早产组预后不良的危险因素为Ⅲ期NEC(OR=6.725,95%CI=2.153~21.01,P=0.001)及并发败血症(OR=3.78,95%CI=1.204~11.873,P=0.023);足月组为Ⅲ期NEC(OR=7.762,95%CI=3.392~15.23,P=0.000)。结论:NEC在早产、足月儿人群发病的围产期因素、并发症、预后危险因素方面存在差异,早产儿并发症更多。Ⅲ期NEC是导致患儿预后不良的共同危险因素,并发败血症是导致早产患儿预后不良的额外危险因素。 Objective：To compare clinical characteristics of necrotizing enterocolitis（NEC）between pre-term and full-term neonates.Methods：Clinical data of 338 patients diagnosed as NEC（Bell＇s stage ≥2） were retrospectively analyzed. Data including perinatal information,complications after NEC diagnosed,basic treatment after NEC diagnosed and risk factors of prognosis were compared between pre-term group（n=94）and term group（n=224）. Results：The incidence of premature rupture of membranes was higher in preterm group（P〈0.05）;sepsis,respiratory failure were more likely happen in neonates after NEC diagnosed in pre-term group（P〈0.05）,and rate of using dopamine,IVIG and infusion of red blood cells were higher in pre-term group（P〈0.05）. Logistic regression analysis discovered that risk factors for mortality in pre-term infants were sepsis（OR=3.78,95%CI=1.204 to 11.873,P=0.023）and NEC stageⅢ（OR=6.725,95%CI=2.153 to 21.01,P=0.001）. While,the risk factors in full-term group were NEC stage Ⅲ（OR=7.762,95%CI=3.392 to 15.23,P=0.000）. Conclusion：There are differences in prenatal factors,clinical complications,treatment measures and risk factors affecting prognosis between pre-term infants and full-term infants with NEC. Pre-term NEC patients have more complications than full-term infants. Sepsis and NEC stage Ⅲ are common risk factors for poor prognosis of pre-term and full-term NEC patients.Sepsis is an extra risk factor for poor prognosis of pre-term NEC patients.

关 键 词： 早产儿 足月儿 坏死性小肠结肠炎 临床对比分析