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目的探讨新生儿坏死性小肠结肠炎(NEC)的发病情况,分析相关危险因素。方法选取2014年5月-2016年3月恩施市中心医院儿科560例新生儿为研究对象,根据NEC发生情况分为NEC组(26例)和非NEC组(534例),回顾性分析临床资料,对NEC组和非NEC组新生儿的一般资料、母亲情况、出生后喂养情况、预防性应用益生菌情况等进行单因素及多因素Logistic回归分析,记录新生儿NEC的独立危险因素。结果 560例新生儿中,确诊为NEC的新生儿26例,发病率为4.64%(26/560)。出生体重、早产、新生儿窒息、新生儿呼吸衰竭、新生儿肺炎、新生儿败血症、感染性休克、母亲妊娠期糖尿病、母亲胎膜早破、产前应用糖皮质激素、产前应用抗生素、喂养方式、开奶量、预防性应用益生菌均为新生儿NEC发病的影响因素(P<0.05)。非条件Logistic多元逐步回归分析结果显示:早产、新生儿败血症、母亲妊娠期糖尿病是NEC发病的独立危险因素(P<0.05);纯母乳喂养及预防性应用益生菌是NEC发病的保护因素(P<0.05)。结论 NEC发病与早产、新生儿败血症、母亲妊娠期糖尿病密切相关,纯母乳喂养及预防性应用益生菌能有效降低NEC的发生风险。
Objective To investigate the incidence of neonatal necrotizing enterocolitis (NEC) and analyze the related risk factors. Methods From May 2014 to March 2016, 560 newborns from Enshi Central Hospital were enrolled and divided into NEC group (n = 26) and non-NEC group (n = 534) according to the occurrence of NEC. The clinical data , The NEC group and non-NEC group neonatal general information, maternal conditions, postnatal feeding, prophylactic use of probiotics, single factor and multivariate logistic regression analysis of neonatal neonatal NEC independent risk factors. Results Of the 560 newborns, 26 newborns were diagnosed as NEC, the incidence rate was 4.64% (26/560). Birth weight, Premature birth, Neonatal asphyxia, Neonatal respiratory failure, Neonatal pneumonia, Neonatal sepsis, Septic shock, Maternal gestational diabetes, Premature rupture of membranes, Prenatal glucocorticoid, Prenatal antibiotics, Feeding Methods, open milk volume, prophylactic use of probiotics are neonatal factors affecting the incidence of NEC (P <0.05). Non-conditional Logistic multiple stepwise regression analysis showed that premature neonates, neonatal sepsis and maternal gestational diabetes mellitus were independent risk factors for NEC (P <0.05); exclusive breastfeeding and prophylactic probiotics were the protective factors of NEC <0.05). Conclusion The incidence of NEC is closely related to prematurity, neonatal sepsis and maternal gestational diabetes, and exclusive breastfeeding and prophylactic use of probiotics can effectively reduce the risk of NEC.