中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
10期
36-39
,共4页
范燕舟%肖政祥%刘玲%谢彩娥%王巧
範燕舟%肖政祥%劉玲%謝綵娥%王巧
범연주%초정상%류령%사채아%왕교
坏死性小肠结肠炎%危险因素%新生儿%预防
壞死性小腸結腸炎%危險因素%新生兒%預防
배사성소장결장염%위험인소%신생인%예방
Necrotizing enterocolitis%Risk factor%Neonate%Prevent
目的：探讨新生儿坏死性小肠结肠炎（NEC）发病的影响因素，为有效预防NEC的发生提供方法。方法回顾性分析两家医院新生儿重症监护室（NICU）于2010年1月~2014年5月收治的NEC患儿63例（观察组）和非NEC患儿70例（对照组）的临床资料共29个项目，应用SAS 9.1统计学软件对其中28项进行单因素分析，将筛选出的主要因素进行多因素回归分析。结果观察组产前应用糖皮质激素，发病前母乳喂养和喂服益生菌，高胆红素血症4个项目的比例低于对照组；观察组胎膜早破、窒息、呼吸窘迫综合征、呼吸衰竭、脐静脉置管、吸氧、败血症、感染性休克、弥漫性血管内凝血（DIC）、先天性心脏病、硬肿症、低钠血症、低钙血症及输血14个项目的比例高于对照组，两组比较，差异有统计学意义（P<0.05）。其余项目，两组差异无统计学意义（P>0.05）。Logistic回归分析显示发病前母乳喂养、喂服益生菌及高胆红素血症为NEC患儿的保护性因素，败血症、先天性心脏病和输血是NEC患儿主要的危险因素。结论 NEC是多种因素综合作用的结果。败血症、先天性心脏病和输血是NEC患儿主要的危险因素；推行母乳喂养、喂服益生菌，避免过度治疗高胆红素血症，可降低新生儿NEC的发生率。
目的：探討新生兒壞死性小腸結腸炎（NEC）髮病的影響因素，為有效預防NEC的髮生提供方法。方法迴顧性分析兩傢醫院新生兒重癥鑑護室（NICU）于2010年1月~2014年5月收治的NEC患兒63例（觀察組）和非NEC患兒70例（對照組）的臨床資料共29箇項目，應用SAS 9.1統計學軟件對其中28項進行單因素分析，將篩選齣的主要因素進行多因素迴歸分析。結果觀察組產前應用糖皮質激素，髮病前母乳餵養和餵服益生菌，高膽紅素血癥4箇項目的比例低于對照組；觀察組胎膜早破、窒息、呼吸窘迫綜閤徵、呼吸衰竭、臍靜脈置管、吸氧、敗血癥、感染性休剋、瀰漫性血管內凝血（DIC）、先天性心髒病、硬腫癥、低鈉血癥、低鈣血癥及輸血14箇項目的比例高于對照組，兩組比較，差異有統計學意義（P<0.05）。其餘項目，兩組差異無統計學意義（P>0.05）。Logistic迴歸分析顯示髮病前母乳餵養、餵服益生菌及高膽紅素血癥為NEC患兒的保護性因素，敗血癥、先天性心髒病和輸血是NEC患兒主要的危險因素。結論 NEC是多種因素綜閤作用的結果。敗血癥、先天性心髒病和輸血是NEC患兒主要的危險因素；推行母乳餵養、餵服益生菌，避免過度治療高膽紅素血癥，可降低新生兒NEC的髮生率。
목적：탐토신생인배사성소장결장염（NEC）발병적영향인소，위유효예방NEC적발생제공방법。방법회고성분석량가의원신생인중증감호실（NICU）우2010년1월~2014년5월수치적NEC환인63례（관찰조）화비NEC환인70례（대조조）적림상자료공29개항목，응용SAS 9.1통계학연건대기중28항진행단인소분석，장사선출적주요인소진행다인소회귀분석。결과관찰조산전응용당피질격소，발병전모유위양화위복익생균，고담홍소혈증4개항목적비례저우대조조；관찰조태막조파、질식、호흡군박종합정、호흡쇠갈、제정맥치관、흡양、패혈증、감염성휴극、미만성혈관내응혈（DIC）、선천성심장병、경종증、저납혈증、저개혈증급수혈14개항목적비례고우대조조，량조비교，차이유통계학의의（P<0.05）。기여항목，량조차이무통계학의의（P>0.05）。Logistic회귀분석현시발병전모유위양、위복익생균급고담홍소혈증위NEC환인적보호성인소，패혈증、선천성심장병화수혈시NEC환인주요적위험인소。결론 NEC시다충인소종합작용적결과。패혈증、선천성심장병화수혈시NEC환인주요적위험인소；추행모유위양、위복익생균，피면과도치료고담홍소혈증，가강저신생인NEC적발생솔。
Objective To investigate influence factors on neonatal necrotizing enterocolitis (NEC) and find a preventive way against the said disorder. Methods A retrospective study was conducted of 63 cases NEC (observation group) and 70 cases non-NEC (control group) admitted to the neonatal intensive care units (NICU) of two hospitals from January 2010 to May 2014. The cases were grouped in 29 factors. The individual factors of 28 out of the 29 factors were analy-sised with SAS 9.1 statistical software, and the screened important factors were investigated by logistic regression. Re-sults The ratios of 4 factors, application of prenatal corticosteroids, breast feeding prior to the ailment, oral probiotics and hyperbilirubinemia in the observation group were lower than those in the control group, while the ratios of 14 factors were higher than those in the control group, premature rupture of membrane, asphyxia, respiratory distress syndrome, respiratory failure, umbilical venous catheters, oxygen uptake, sepsis, septic shock, disseminated intravascular coagula-tion (DIC), congenital heart disease, scleredema, hyponatremia, hypocalcaemia and transfusion. The differences of fac-tors mentioned were of statistic significance (P<0.05), while the differences of other factors were not statistically signifi-cant between the two groups (P>0.05). Logistic regression analysis indicated that breast feeding, oral probiotics and hy-perbilirubinemia were protective factors against NEC; while sepsis, congenital heart disease and transfusion were major factors that lead to NEC. Conclusion NEC resulted from a combination of multiple factors, with sepsis, congenital heart disease and transfusion as the leading ones. Breast feeding, oral probiotics, and non-excessive curing against hyper-bilirubinemia will help reduce the incidence of NEC.
