早产儿坏死性小肠结肠炎临床特点分析

目的　比较早产儿与足月儿坏死性小肠结肠炎 (necrotizingenterocolitis ,NEC)临床特点。　方法　回顾性分析 1994至 2 0 0 3年我所收治的早产NEC患儿 2 8例和足月NEC患儿 3 5例的临床表现、X线表现和实验室检查特点。　结果　早产儿组与足月儿组比较皮肤灰白 5 4% (15 / 2 8)和 2 6% (9/ 3 5 ) ,P <0 .0 5 )、肌张力低下 [4 6% (13 / 2 8)和 14 % (5 / 3 5 ) ,P <0 .0 1]等全身表现明显 ;肠鸣音减弱或消失比足月儿组多见 [5 7% (16/ 2 8)与 2 3 % (8/ 3 5 ) ,P <0 .0 1] ;代谢性酸中毒 [5 4% (15 / 2 8)和 2 3 % (8/ 3 5 ) ,P <0 .0 5 ]和血清尿素氮增高 [3 6% (10 / 2 8)和 14 % (5 / 3 5 ) ,P <0 .0 5 ]比例高。　结论　早产儿NEC病情严重 ,进展迅速 ,应该给予及时正确的处理。并对发病趋势、发病日龄、早期诊断和手术治疗进行了讨论。

Analysis of the clinical characteristics of necrotizing enterocolitis in premature neonates

Objective To study the clinical characteristics of necrotizing enterocolitis(NEC) in premature neonates. Methods Twenty eight premature and 35 full term neonates with NEC in our hospital from 1994 to 2003 were enrolled in this retrospective study. The clinical manifestation, X ray and laboratory results were analyzed. Results The presentations of premature group were more severe than that of the full term group,such as poor perfusion (54% vs 26%, P <0.05) and flaccidity (46% vs 14%, P <0.01), bowel sounds decrease/absent (57% vs 23%, P <0.01), the incidence of metabolic acidosis (54% vs 23%, P <0.05) and serum BUN elevation (36% vs 14%, P <0.05) Conclusions NEC in premature neonates is severe and progresses aggressively and should be managed promptly and properly.