Analysis Of Risk Factors And Early Clinical Characteristics Of Neonatal Necrotizing Enterocolitis

ObjectiveThrough the statistical analysis of the clinical data of NEC,to explore the risk factors and early clinical characteristics of neonatal necrotizing enterocolitis（NEC）,improve the early warning,timely intervene the early cases and improve the prognosis of NEC.MethodsThis study used to case-control method,and 95 children with NEC diagnosed in the pediatric NICU of the first people’s Hospital of Yunnan Province from November 22,2017 to November 22,2020 were collected.According to the 1 ∶ 1 matching ratio,95 non-NEC children in the same period were selected as the control group.The collected data included the data of perinatal children and their mothers,as well as the clinical diagnosis and treatment data of the children during hospitalization.The above clinical data were retrospectively analyzed by statistical methods,and finally the conclusion was dtawn.Results1.Multivariate binary logistic regression analysis showed that the P values of preterm birth,low birth weight,infection and mechanical ventilation were all less than 0.05.2.Clinical symptoms were analyzed by χ2 test,and the results showed that the P values of the early NEC group were all less than 0.05,such as poor response,feeding intolerance and gastric retention.3.Spearman rank correlation test was used to analyze the inflammatory indexes of NEC cases.The results showed that the difference of leukocyte deviation from normal value,C-reactive protein and procalcitonin were all less than 0.05.The ROC curve showed that the specificity of C-reactive protein and procalcitonin was lower than that of leukocytes,but their sensitivity was higher than that of leukocytes.4.Routine fecal examination showed that the probability of occult blood positive was not high,only 11.6%.The main manifestation of NEC in early abdominal standing X-ray was enterocele,accounting for 94.7%.Conclusion1.The main clinical manifestations of early NEC are poor response,feeding intolerance and gastric retention.Routine fecal examination is not of high diagnostic value for early NEC.2.NEC is accompanied by the increase of inflammatory indexes,and the changes of C-reactive protein and procalcitonin are more conducive to the evaluation of the disease.Early NEC abdominal X-ray examination showed no characteristic changes,only intestinal gas accumulation.3.Mechanical ventilation,premature delivery,low body weight and infection are independent high-risk factors for NEC.For children with the above high-risk factors,when they have poor clinical response,abdominal distension,gastric retention,and increased inflammatory indicators,and imaging examination indicates that there is gas in the intestinal cavity,they should pay close attention to the changes of abdominal signs,dynamically perform abdominal X-rays,improve the early diagnosis rate of NEC,and timely intervene.