Clinical Analysis Of The Risk Factors In Neonates With Neonatal Necrotizing Enterocolitis In A Grade Ⅲ-A Hospital From 2011 To 2017

Objective:Neonatal necrotizing enterocolitis(necrotizing enterocolitis,NEC)disease and need to be a risk factor for surgical treatment of NEC,for the early prevention of NEC,clinical diagnosis and treatment,and provide theoretical basis to further reduce the rate of surgical intervention.Methods:Selection in October 2011 to October 2017 in the first affiliated hospital of anhui medical university obstetrics was born and in the Neonatal Intensive Care Unit(Neonatal Intensive Care Unit,NICU)admitted to observe 133 cases of children with confirmed NEC group of randomly selected in the same period in the hospital,140 cases of non NEC newborn as control group,the clinical data of 273 cases of children enrolled in the study: including quality,gestational age,sex,birth,mother’s day age pregnancy complications(with or without infection during pregnancy,gestational diabetes,gestational hypertension disease,and premature rupture of membranes),delivery methods,Apgar score and whether history of asphyxia recovery,feeding way,add milk,on basis of disease,clinical manifestation,laboratory examination,the result of drug susceptibility,treatment(including whether the use of prophylactic antibiotics and probiotics,blood transfusion,respiratory support)and outcome of clinical data were retrospectively analysed,all exposure factors of NEC,single factor variance analysis for single factor with statistically significant Logistic multivariate regression analysis.At the same time,NEC’s observation group was confirmed to be divided into surgical treatment group and non-surgical treatment group to carry out Logistic multivariate regression analysis for all exposure factors.Results:(1)of the 7379 patients admitted to the hospital in 6 years,there were 133 confirmed cases of NEC,and the incidence of NEC was 1.8%,including 44 cases(33.1%)of NEC I,54 cases(40.6%)in phase II and 35 cases in stage III(26.3%).NEC’s case fatality rate was 23.1%.(2)among the 133 patients diagnosed with NEC,92 cases(69.17%)were treated with conservative treatment,and 41 cases(30.83%)were treated with surgical treatment.(3)the results of single factor analysis in this group showed that premature rupture of membranes,septicemia,asphyxia,mechanical ventilation and feeding mode were related to the occurrence of NEC(P < 0.05).Premature rupture of membranes(4)to further,sepsis,suffocation,mechanical ventilation and the way of feeding the five have statistical significance of the single factor logistic multivariate regression analysis showed that: premature rupture of membranes,sepsis,mechanical ventilation for NEC independent risk factors of the disease,breastfeeding is NEC protective factors.(5)the data in this group showed that the risk factor for surgical treatment after the diagnosis of NEC was the combination of NRDS,sepsis and mechanical ventilation.Conclusion:The results of this study showed that the incidence of NEC in neonatal NICU was 1.8%and the mortality rate was 23.1%.Premature rupture of membranes,sepsis,mechanical ventilation is a risk factor for premature in NEC,breastfeeding is NEC protective factors,when has the high risk factors to improve ability to recognize our vigilance against the possible NEC and prevention,early effective intervention therapy;Efforts to improve the exclusive breastfeeding rate of premature infants in NICU.Of NEC has been diagnosed with,when the combination of NRDS,sepsis and mechanical ventilation should be monitoring changes,dynamic follow-up abdominal imaging abdominal signs,for the right NEC surgical operation time,reduce the incidence and mortality,reduce the NEC children nearly/long-term complications,to improve the long-term prognosis.