Study On The Clinical Efficacy And Safety Of Decompression Reflux Enema In The Treatment Of NEC

Objective:In this study,the clinical efficacy and safety of decompression reflux enema in the treatment of NEC were analyzed by retrospectively studying the clinical data of neonates with necrotizing enterocolitis(NEC).Methods and subjects:The clinical data of pediatric surgery and neonatal hospitalization in our hospital for diagnosis of necrotizing enterocolitis(NEC)from January 2014 to September 2019 were retrospectively analyzed.The observation items included:general information,clinical symptoms,WBC,CRP,PCT,changes in abdominal circumference,length of hospital stay,recovery time of enteral nutrition and related complications.Grouting criteria:(1)220 neonatal patients with necrotizing enterocolitis were divided into control group and treatment group according to whether they received reflow enema treatment or not.The control group was given routine treatment,and the treatment group was given reflux enema on top of routine treatment.The improvement of clinical symptoms,treatment effect and incidence of complications were compared between the two groups.(2)Because the prognosis of neonatal necrotizing enterocolitis varies greatly with different Bell grades,all the children were divided into three groups according to the clinical stages of Necbell,NECI stage,Ⅱa stage and Ⅱb stage respectively for comparison.Results:1.The effective rate of treatment:the effective rate of 3 days and 7 days in I enema group were 90.3%and 96.8%,respectively,which were higher than 67.2%and 82%in the control group(P<0.05).II The effective rates of 3-day and 7-day treatment in Stage A enema group were 97.36%and 100%,which were both higher than the 51.5%and 78.8%of the control group(P<0.05).The effective rates of 3-day and 7-day treatment in Stage B enema group were 73.2%and 90.3%,respectively.Those in the control group were 47.8%and 52.2%(P<0.05).2.Infection indicators:WBC,CRP and PCT of the Ⅰ stage NEC children gradually decreased after treatment,and WBC,CRP and PCT of the enema group were lower than those of the control group after 3 and 7 days of treatment(P<0.05).Ⅱ After stage A treatment,WBC,CRP and PCT of the enema group were lower than those of the control group at 3 and 7 days after treatment(P<0.05).II WBC,CRP and PCT of stage B enema group were lower than those of control group after 3 and 7 days of treatment(P<0.05).3.Recovery:abdominal circumference of NEC:I abdominal circumference at 3 and 7 days after treatment was 2.58±1.54cm and 4.11±1.96cm,respectively,compared with 1.51±0.56cm and 2.62±0.99cm in the control group,the effect was significant(P<0.05).The recovery time and hospitalization time of enteral nutrition in the enema group were 4.3±1.9 days and 6.4±1.9 days,and in the control group were 6.6±2.3 days and 10.8±3.2 days,which were significantly shortened(P<0.05).Ⅱ The changes of abdominal circumference at 3 and 7 days after stage A treatment were 3.8±2.2cm and 5.8±2.1cm,respectively,compared with 2.3±2.1cm and 3.3±2.4cm in the control group,the effect was significant(P<0.05).The recovery time and hospitalization time of enteral nutrition were 4.7±2.3 days and 9.3±2.8 days in the enema group,and 9.1±2.9 days and 16.5±5.8 days in the control group,which were significantly shortened(P<0.05).II The abdominal circumference at 3 and 7 days after stage B treatment was 2.5±2.4cm and 4.1±2.5cm,respectively,compared with 0.7±0.6cm and 2.3±1.3cm in the control group,and the effect was significant(P<0.05).The recovery time and hospitalization time of enteral nutrition were 6.1±2.4 days and 10.9±5.3 days in the enema group,and 10.6±3.9 days and 18.3±3.9 days in the control group,which were significantly shortened(P<0.05).4.Incidence of complications:The incidence of sepsis and DIC in the enema group was lower than that in the control group(P<0.05),and the incidence of septic shock,DIC,metabolic acidosis,positive fecal occult blood,pneumoperitoneum and electrolyte disturbance was lower than that in the control group(P>0.05).Conclusion:This study found that the reduced pressure backflow enema in the treatment of NEC clinical effect is exact,is a kind of can effectively alleviate NECBell stage all the patient’s clinical symptoms,reduce inflammatory reaction,improve the gastrointestinal function,shortening the time of fasting and hospitalization time,to get better treatment effect and to improve prognosis,and lower incidence of complications of treatment,worthy of clinical application.