Zhao Xuwen,Hu Bo,Dai Chunjuan,et al.Risk factors of intestinal perforation in neonatal necrotizing enterocolitis[J].Journal of Clinical Pediatric Surgery,,20():1042-1047.[doi:10.12260/lcxewkzz.2021.11.009]
Risk factors of intestinal perforation in neonatal necrotizing enterocolitis
- Keywords:
- Necrotizing Enterocolitis; Intestinal Perforation; Risk Factors; Infant; Newborn
- CLC:
- R574.5;R726.566.22;R722
- Abstract:
- Objective To explore the risk factors of intestinal perforation in neonatal necrotizing enterocolitis (NEC) and provide references for its clinical diagnosis and treatments. Methods From September 2016 to December 2019, 32 children of NEC with intestinal perforation fulfilling the inclusion criteria were enrolled and 96 controls admitted simultaneously without intestinal perforation selected as control group. General data (gestational age, birth weight, gender, onset age of NEC, NEC onset to intestinal perforation) and perinatal data (maternal gestational age & uterine age) were collected retrospectively. Internal distress, premature rupture of membranes, mode of delivery, pregnancy with diabetes, pregnancy-induced hypertension & pregnancy infection), complications after NEC diagnosis (respiratory failure, shock, sepsis, coagulation dysfunction, hypocalcemia, damage of liver & kidney function, hypokalemia & hyperkalemia) and testing results at NEC onset (leukocytes, platelets, hemoglobin, PCT, CRP & albumin) were collected. Both single and multiple factor Logistic regression analyses were performed for summarizing the risk factors of intestinal perforation in NEC. Results Single factor analysis revealed significant differences between NEC with intestinal perforation and birth weight, gestational age, maternal gestational age, infection during pregnancy, respiratory failure, shock, septicemia, coagulation dysfuncton, impaired renal function, hypocalcemia, hypokalemia, leukocyte, platelet, hemoglobin, PCT, CRP and albumin (P<0.05). Multivariate logistic regression analysis indicated that coagulation dysfunction (OR=7.125, 95%CI:2.095-24.230) and hypokalemia (OR=6.627, 95%CI:1.557-28.205) were independent risk factors of intestinal perforation in NEC while high albumin (OR=0.792, 95%CI:0.694-0.905) and leukocyte count (OR=0.917, 95%CI:0.844-0.995) were protective factors. Conclusion Coagulation dysfunction, hypokalemia, low leukocyte count and low albumin are independent risk factors of intestinal perforation in NEC. Early identification of risk factors and timely intervention should be performed for preventing intestinal perforation of neonatal NEC.
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Memo
收稿日期:2020-05-01。
基金项目:天津市卫生健康科技项目（编号：RC20020）；天津市儿童医院发展基金计划项目（编号：Y2020006）
通讯作者:胡博,Email:surgeonhubo@163.com