在出生时体重非常低的新生儿中,自发肠道穿孔后发生死性肠球炎
Goeto Dantes1, Olivia A Keane2, Swathi Raikot3
1Department of Surgery, Emory University, Atlanta, GA, USA. gdantes@emory.edu.
概括
在早产婴儿的自发性肠穿孔 (SIP) 治疗后,死性肠球炎 (NEC) 可能发生. 这项研究发现SIP后NEC的发病率为11.2%,导致住院时间更长.
科学领域:
- 新生儿手术 新生儿手术
- 胃肠病学 胃肠病学
- 儿科重症监护 儿科重症监护 儿科重症监护
背景情况:
- 结核性肠球炎 (NEC) 和自发性肠孔 (SIP) 是早产婴儿严重的胃肠道问题.
- 虽然NEC和SIP具有重叠的临床特征和治疗方法,但它们的潜在原因不同.
- 接受SIP治疗的患者可能以后发展为NEC,这种现象在没有风险因素分析的情况下很少被记录.
研究的目的:
- 评估SIP初始诊断和治疗后为NEC治疗的新生儿的临床特征,风险因素和结果.
- 确定潜在的风险因素,并了解SIP后NEC发展的发生率.
主要方法:
- 从2004年至2022年进行了一项对出生时体重非常低的新生儿 (<1500g) 进行的回顾性审查,这些新生儿患有肺.
- 最初被诊断为NEC的患者被排除在外. 分析了那些接受SIP治疗的人 (通过腹膜排水或腹腔切除术).
- 在SIP治疗后开发NEC的患者与仅使用SIP的患者进行了比较,检查了人口统计数据,风险因素和停留时间.
主要成果:
- 在278名患者中,31人 (11.2%) 在SIP后发展出NEC,平均发病时间为56天.
- 在SIP后的NEC和SIP单独组之间没有观察到妊娠年龄或出生体重的显著差异.
- 在SIP后的NEC与较长的停留时间 (135 vs 81天) 和腹腔切除术 (初级或失败的排水) 后的发病率较高,与单独的腹腔内排水相比.
结论:
- 在SIP治疗成功后,观察到NEC的发病率为11.2%,中位数为56天,显著增加了停留时间.
- 接受SIP治疗的新生儿代表了开发NEC的高风险群体.
- 对SIP患者中NEC的预防方案进行进一步的研究是有必要的.
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