| Neonatal necrotizing enterocolitis is a common acquired acute abdominal disease in newborns.85%of them are premature infants.The incidence of the disease is rising year by year,the severe cases are progressing rapidly,and the mortality rate is high.The overall incidence of NEC is about 0.1%to 0.3%.The incidence of NEC in very low birth weight infants is about 5%to 10%,and the mortality is about 20%to50%.The pathogenesis of NEC is complex,the pathogenesis is not yet clear,early diagnosis is difficult,and the effective prevention and control measures are lacking in clinical.NEC has become one of the most difficult problems in neonatal diseases.ObjectiveIn order to provide theoretical basis for early prevention,early diagnosis and prognosis of neonatal necrotizing enterocolitis,the distribution and clinical characteristics of necrotizing enterocolitis in the Third Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Materials and MethodsIn this study,a retrospective study was conducted to investigate the medical records of all NEC children diagnosed as NEC from2011/01/01-2016/12/31.The clinical data of all NEC children were recorded and analyzed.According to whether the operation was divided into operation group and non-operation group,the prognosis risk factors of the operation group were analyzed and discussed.The premature infants and full-term infants were divided into according to gestational age.The risk factors and prognosis of the two groups were compared.The quantitative data were expressed with?x±s,and t test was used among groups.χ~2 test,correction ofχ~2 test or Fisher accurate probability test were used among the qualitative data groups,and multiple factors were analyzed by Logistic analysis.Result1.In past 6 years,237 cases of neonatal necrotizing enterocolitis were treated in our hospital,of which 119 cases were boys(50.21%),118 cases were girls(49.78%),premature infants were 177 cases(74.68%),ful-term infants were 60 cases(25.32%),average gestational age of them was 34.02±3.05 weeks,average birth weight of them was 1933.51±729.57g;3 cases of them were related to blood transfusion and 2cases were related to Human Immunoglobulin.209 cases(88.19%)of them with more than grade II NEC.76 cases were treated with surgery,of which 40 cases(52.63%)were survived and 36 cases(47.37%)were died,of which 6 cases of the survivors had complications,including 3 cases short bowel syndrome(7.5%),intestinal stenosis 2cases(5%).2.The incidence of NEC in our hospital in the last 6 years were3.45/1000、5.55/1000、8.53/1000、13.50/1000、14.62/1000、11.29/1000 respectivel,it was on the rise.3.It happens all the year round,which was more common in summer and autumn.4.The incidence of clinical manifestations with NEC were abdominal distention218 cases(91.98%),vomiting 89 cases(37.55%),blood stool 82 cases(34.60%),respiratory apnea in 69 cases(29.11%),mental malaise 55 cases(23.21%),fever 47cases(19.83%),etc.5.Risk factors influence the outcome of NEC in full-term newborn were neonatal infection,congenital megacolon,while premature infants were smaller gestational age,sepsis,low birth weight,RDS series above classⅡ,exposure antibiotics,congenital heart disease,metabolic acidosis,central venous catheter and so on,the differences were statistically significant(p<0.05).Further Logistic analysis,independent risk factors for premature infants were gestational age(OR=5.59,95%CI=1.995-15.672),sepsis(OR=5.17,95%CI=1.907-14.027),Full-term infants were neonatal infection(OR=24.78,95%CI=2.10-260.54),congenital megacolon(OR=7.62,95%CI=1.40-41.45).(P<0.05).6.The mortality rate in the operation group was47.37%.The risk factors affecting the prognosis of the operation group were small gestational age,low birth weight,abdominal wall red and swelling,septicemia,respiratory failure,shock,severe metabolic acidosis,renal failure and so on.The difference was statistically significant(P<0.05).Conclusion1.With the increase of the survival rate of preterm infants,the incidence of NEC is increasing year by year in our hospital.The preterm infant accounts for 74.68%of NEC cases and the cure rate of NEC is 64.14%in our hospital;2.Though occurred in every month,which was more common in summer and autumn.3.Smaller gestational age and sepsis are independent risk factors of premature NEC;Infection and congenital megacolon are independent risk factors for full-term infants;... |
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