Clinical Analysis Of 128 Cases Of Neonatal Necrotizing Enterocolitis

Objective: This paper is to research and analysis the clinical manifestations,common complications,perinatal factors,auxiliary examination and outcome of neonatal necrotizing enterocolitis(NEC)in preterm infants and term infants,and the risk factors that may affect the clinical outcome of children with NEC,provide evidence-based support for the treatment of neonatal necrotizing enterocolitis.Methods: 128 neonates of Children’s Hospital of Soochow University from January 2013 to September 2016 were recruited in this study.They were divided into two groups,preterm infants and term infants.Then we made a comparison of clinical manifestations,common complications,perinatal factors,auxiliary examination and outcome between them,and made logistic regression analysis of the high risk factors that may affect the clinical outcome of children with NEC.Results:1.Morbidity and mortality: In this study,the cases of NEC accounted for 0.93% of neonatal hospitalization.The morbidity of preterm infants was higher than that of term infants.And the morbidity increased with the decrease of birth weight.In this study,the mortality of NEC was 21.88%,which increased with the severity of NEC.2.Onset time: The onset time of preterm infants was later than term infants.In preterm infants,the onset time of children which gestational age less than 32 weeks was later than others.3.In this study,bloating and blood was the most common clinical manifestations of NEC.The incidence rate of apnea in preterm infants was higher than that of term infants.It had no statistical significance of the incidence rate of gastric retention and intestinal perforation between preterm infants and term infants.4.There was no specificity of the incidence of white blood cells counts,C-reactive protein,procalcitonin,etc.in the auxiliary examination.The abdominal X-ray score increased with the severity of NEC.5.The incidence rate of premature rupture of membranes,anemia,and use antibiotics within 1 week before onset in preterm infants was higher than that of term infants.6.The univariate analysis showed that the prognosis of NEC was related to the factors such as leukocyte disorder,elevated procalcitonin,metabolic acidosis,hyponatremia,severe abdominal X-ray abnormalities,disseminated intravascular coagulation,and shock,and the further logistic regression analysis revealed that elevated procalcitonin,shock,metabolic acidosis were main risk factors for the clinical outcome of NEC.Conclusions:1.The morbidity of neonatal necrotizing enterocolitis in preterm infants was higher than that of term infants.The morbidity was negatively correlated with birth weight.2.The onset time of preterm infants,especially smaller gestational age,was later than term infants.3.In this study,bloating and blood was the most common clinical manifestations of NEC.The incidence rate of apnea,gastric retention and intestinal perforation in preterm infants was higher than that of term infants.4.There was no specificity of the laboratory examination.Abdominal X-ray score was helpful for determine the severity of NEC.5.Elevated procalcitonin,shock,metabolic acidosis were main risk factors for the clinical outcome of NEC.