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目的探讨新生儿坏死性小肠结肠炎(NEC)发病的危险因素。方法回顾性分析2008—2011年3家医院新生儿重症监护病房收治的NEC患儿(观察组)及非NEC患儿(对照组)的临床资料,包括产科因素、产时情况、新生儿一般情况、NEC发病前疾病情况及有无应用益生菌等28个项目,应用SAS软件进行单因素和多因素分析。结果观察组92例,对照组130例,两组胎龄和出生体重差异均无统计学意义(P>0.05)。单因素分析显示,观察组产时窒息、肺炎、呼吸衰竭、生后吸氧、败血症、感染性休克、弥漫性血管内凝血、低钠血症和低钙血症的比例高于对照组,产前应用糖皮质激素、发病前喂养、高胆红素血症和口服益生菌的比例低于对照组,差异均有统计学意义(P<0.05),其余各项两组差异无统计学意义(P>0.05);Logistic回归分析显示,高胆红素血症(OR=0.205)和口服益生菌(OR=0.056)为新生儿NEC的保护因素,肺炎(OR=3.645)和败血症(OR=7.826)为危险因素。NEC组患儿发病前喂养率明显低于对照组(OR=0.072,95%CI0.010～0.501,P<0.01)。结论肺炎、败血症是新生儿NEC发病的危险因素,高胆红素血症、口服益生菌是新生儿NEC发病的保护因素,发病前喂养率低与基础疾病致延迟开奶有关。
Objective To investigate the risk factors of neonatal necrotizing enterocolitis (NEC). Methods The clinical data of obstetric patients, non-NEC infants (control group) and neonatal intensive care unit (NICU) admitted to three hospitals from 2008 to 2011 were retrospectively analyzed. , Pre-NEC disease status and the presence or absence of probiotics and other 28 projects, using SAS software for univariate and multivariate analysis. Results There were 92 cases in the observation group and 130 cases in the control group. There was no significant difference in gestational age and birth weight between the two groups (P> 0.05). Univariate analysis showed that the production rate of asphyxia, pneumonia, respiratory failure, postnatal oxygen inhalation, sepsis, septic shock, diffuse intravascular coagulation, hyponatremia and hypocalcemia in the observation group were higher than those in the control group Before the application of glucocorticoids, the incidence of pre-feeding, hyperbilirubinemia and oral probiotics lower than the control group, the difference was statistically significant (P <0.05), the rest of the two groups showed no significant difference ( Logistic regression analysis showed that hyperbilirubinemia (OR = 0.205) and oral probiotics (OR = 0.056) were the protective factors of neonatal NEC. Pneumonia (OR = 3.645) and sepsis (OR = 7.826 ) As a risk factor. The incidence of pre-nosocomial feeding in NEC group was significantly lower than that in control group (OR = 0.072, 95% CI0.010-0.501, P <0.01). Conclusions Pneumonia and sepsis are the risk factors of neonatal NEC. Hyperbilirubinemia and oral probiotics are the protective factors of neonatal NEC. The low incidence of pre-natal feeding is related to the delayed opening of milk caused by underlying diseases.