摘要
目的探讨极低出生体重儿坏死性小肠结肠炎(NEC)的发生率和高危因素。方法回顾性分析我院2006年8月至2011年4月在重症监护室住院时间>24h的极低出生体重儿,按照是否合并NEC分为病例组和对照组,对两组进行21个相关单因素及多因素分析。结果 323例极低出生体重儿发生Ⅱ期以上NEC20例,发生率6.2%。单因素分析显示,病例组医院感染败血症(χ2=29.449)、前置胎盘(χ2=6.648)、和先天性心脏病(χ2=11.353)的比例较对照组明显增加,早期微量喂养(χ2=8.355)的比例低于对照组,开奶时间较对照组延迟[8.5(3.3～15)天比3.0(2～7)天,Z=2.921],P均<0.05。多因素Logistic回归分析显示,医院感染败血症(OR9.050,95%CI3.272～25.030)、前置胎盘(OR6.841,95%CI1.491～31.392)和开奶延迟(OR1.065,95%CI1.007～1.127)是NEC发病的高危因素(P均<0.05)。结论医院感染败血症、前置胎盘、延迟开奶是NEC发病的危险因素。尽早开展微量喂养,积极预防极低出生体重儿医院感染,有助于降低NEC发生率。
Objective To investigate the incidence and risk factors of necrotizing enterocolitis（NEC） among very low birth weight infants（VLBWI）.Methods Clinical and laboratory data of 323 VLBWI are retrospectively analyzed,who are admitted to the neonatal intensive care unit of Medical Centre for Maternal Child Health Municipal Hospital,Suzhou from Aug.2006 to Apr.2011.They are more than 24 hours of life at hospital and assigned into two groups：group Ⅰ（infants with NEC,Bell stage≥Ⅱ）,group Ⅱ（infants without NEC）.All 21clinical variables are recorded and multivariate logistics regression model are created to examine effects on the risk of NEC,and the results are analyzed by SPSS 10.0.Results There are 20 patients with NEC among 323 VLBWI,the incidence of NEC is 6.2%.The results show that nosocomial infection,placentaprevia,delay in commencement of feeding,early minimal enteral feeding and congenital heart disease（χ2=29.449,χ2=6.648,z=2.921,χ2=8.355 and χ2=11.353,P0.05）are different from the NEC infants.Logistic analysis shows that nosocomial infection（OR 9.050,95%CI 3.272-25.030）,placentaprevia（OR 6.841,95% CI 1.491-31.392） and time of beginning feeding（OR 1.065,95%CI,1.007-1.127） are the highest risk factor of NEC.Conclusions Nosocomial infection,placentaprevia and delay in commencement of feeding are the highest risk factor of NEC,preventative for nosocomial infection and early minimal enteral feeding for serious very low birth weight infants are helpful to prevent the incidence of NEC.
出处
《中国新生儿科杂志》
CAS
2012年第2期78-81,共4页
Chinese Journal of Neonatology
