影响足月和早产儿坏死性小肠结肠炎预后的危险因素分析

Analysis of risk factors influencing the prognosis of full-term and preterm infants with necrotizing enterocolitis

摘要:

目的：探讨影响足月和早产新生儿坏死性小肠结肠炎（neonatal necrotizing enterocolitis，NEC）预后的危险因素。方法：回顾性分析287例（BEIL分期≥Ⅱ期）NEC患儿临床资料，根据胎龄分为足月组（128例）和早产组（159例），然后采用单因素分析和多因素logistic回归分析，总结影响足月儿和早产儿NEC预后的危险因素。结果：足月组NEC分析显示，Ⅲ期NEC（OR=63.052，95%CI=2.373~1674.987，P=0.013）和并发呼吸衰竭（OR=85.917，95%CI=3.005~2456.151，P=0.009）是影响其预后的独立危险因素，使用益生菌（OR=0.036，95%CI=0.002~0.809，P=0.036）为其保护因素。早产组NEC分析显示，并发败血症（OR=5.669，95%CI=1.829~17.569，P=0.003）是影响其预后的独立危险因素，使用益生菌（OR=0.172，95%CI=0.054~0.547，P=0.003）为其保护因素。结论：影响早产儿和足月儿NEC预后的危险因素有一定差异，临床上应采取个体化处理以改善预后。

Abstract:

Objective：To investigate risk factors influencing prognosis of neonatal necrotizing enterocolitis（NEC） in full-term infants and preterm infants. Methods：The clinical data of 287 NEC patients（BELL stage≥Ⅱ） were retrospectively analyzed and divided into full-term group（n=128） and the preterm group（n=159） according to gestational age. and then use The univariate and multivariate logistic regression analysis was used to summarize risk factors influencing NEC prognosis in full-term and preterm infants. Results：NEC analysis in the full-term group showed that Ⅲ-stage NEC（OR=63.052，95%CI=2.373-1674.987，P=0.013） and complication of respiratory failure（OR=85.917，95%CI=3.005-2456.151，P=0.009） were independent risk factors for prognosis；probiotics（OR=0.036，95%CI=0.002-0.809，P=0.036） was protective factor. NEC analysis in the preterm group showed that sepsis（OR=5.669，95%CI=1.829-17.569，P=0.003） was independent risk factor influencing prognosis，and probiotics（OR=0.172，95%CI=0.054-0.547，P=0.003） was protective factor. Conclusion：There are some differences in risk factors of NEC prognosis in preterm and full-term infants，and clinical treatment should be individualized to improve prognosis.