Cl Inical Characteristics And Risk Factors Of Necrotizing Enterocolitis In Term Infants And Preterm Infants

Objective: The risk factors,clinical features and prognosis of necrotizing enterocolitis(NEC)in premature and term infants were compared.Methods: Three hundred and twenty-five neonates who diagnosed with necrotizing enterocolitis at the Children’s Hospital of Chongqing Medical University from 2016 to 2018,were retrospectively analyzed with the clinical data and divided into term infant group and preterm infant group according to their gestational age.Compared the differences of two groups on age of onset,clinical manifestations and major complications.Results: There were 137 cases in the premature infant group and 188 cases in the full-term infant group.Blood stool,abdominal distension,vomiting,and hypoactive bowel sounds were the main manifestations of the two groups of neonates,among which blood stool(84.57% vs 66.42%)and vomiting(46.28% vs 28.47%)were the most clinical manifestations of the full-term infants(P<0.05),and abdominal distension(82.48% vs55.32%),hypoactive bowel sounds(79.56% vs 69.68%),hypotonia(40.15% vs 7.45%),exposed epigastric veins(23.36% vs 2.66%),intestinal perforation(23.36% vs 5.32%)were the most clinical manifestations of the premature infants(P<0.05).The incidence of NEC complications in the premature infant group was significantly higher than that in the full-term infant group(P<0.05),including respiratory distress syndrome(10.95% vs0.53%),neonatal pneumonia(87.59% vs 78.19%),sepsis(53.28% vs31.38%),respiratory failure(33.58% vs 3.72%),coagulation dysfunction(41.61% vs 15.96%)and so on.In the premature infant group,more positive laboratory examinations were found than that in the full-term infants group,with increased or decreased white blood cells(41.61% vs21.81%),decreased plateletes(18.98% vs 6.91%),and the abdominal X-ray of the premature infants showed more stageⅡ or stage Ⅲ(78.83% vs52.13%).Neonatal necrotizing enterocolitis mostly has a poor prognosis in stage Ⅱ-Ⅲ,and the prognosis of premature infants is significantly worse than that of full-term infants(29.20% vs 7.45%)(P<0.001).Neonatal sepsis,neonatal shock and congenital heart disease were independent risk factors affecting the clinical outcome of NEC(P<0.05).Conclusion: Preterm infants and full-term infant in the performance of the NEC each have emphasize particularly on.In the premature infant group,there were many complications,mostly positive laboratory examinations,severe abdominal radiographs and poor prognosis.