手术治疗的足月与早产新生儿坏死性小肠结肠炎临床特点的对比分析

李俊利; 韦欢; 谭琪; 曹建; 朱婷; 张阳; 史源; 王政力

doi:10.7499/j.issn.1008-8830.2412028

中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (05) : 595 -600. DOI: 10.7499/j.issn.1008-8830.2412028

论著·临床研究

手术治疗的足月与早产新生儿坏死性小肠结肠炎临床特点的对比分析

李俊利 ¹ ,
韦欢 ¹ ,
谭琪 ¹ ,
曹建 ¹ ,
朱婷 ¹ ,
张阳 ¹ ,
史源 ¹^,² ,
王政力 ¹^,²

作者信息 +

Comparative analysis of clinical characteristics of term and preterm neonates with necrotizing enterocolitis undergoing surgery

Jun-Li LI ¹ ,
Huan WEI ¹ ,
Qi TAN ¹ ,
Jian CAO ¹ ,
Ting ZHU ¹ ,
Yang ZHANG ¹ ,
Yuan SHI ¹^,² ,
Zheng-Li WANG ¹^,²

Author information +

文章历史 +

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摘要

目的分析手术治疗的足月儿和早产儿新生儿坏死性小肠结肠炎（necrotizing enterocolitis, NEC）临床特点的差异。方法回顾性分析重庆医科大学附属儿童医院2017年6月—2023年8月接受手术治疗的142例NEC患儿的临床资料。根据胎龄分为早产儿组（胎龄<37周，95例）和足月儿组（37周≤胎龄<42周，47例），比较两组临床特点的差异。结果早产儿组诊断日龄、手术日龄大于足月儿组（P<0.05）。早产儿组术前出现血便比例、术前血小板计数低于足月儿组，术前出现呼吸困难、呼吸暂停、肠鸣音减弱/消失比例，以及机械通气比例高于足月儿组（P<0.05）。早产儿组术后出现化脓性脑膜炎、败血症、凝血功能障碍比例高于足月儿组，术后血小板计数、术中最低体温低于足产儿组（P<0.05）。结论 NEC手术治疗的早产儿、足月儿的临床特点有显著差异，应根据其特点制定相应的围手术期管理方案。

Abstract

Objective To study the differences in clinical characteristics of term and preterm neonates with necrotizing enterocolitis (NEC) undergoing surgical treatment. Methods A retrospective analysis was conducted on the clinical data of 142 NEC neonates who underwent surgery at the Children's Hospital of Chongqing Medical University from June 2017 to August 2023. The neonates were categorized into a preterm group (gestational age <37 weeks; 95 cases) and a term group (gestational age 37-42 weeks; 47 cases) to compare clinical characteristics. Results The preterm group had a higher postnatal age at both diagnosis and surgery compared to the term group (P<0.05). The preterm group also had a higher incidence of preoperative bloody stools, lower preoperative platelet counts, and higher rates of preoperative respiratory distress, apnea, reduced/absent bowel sounds, and mechanical ventilation compared to the term group (P<0.05). Postoperatively, the preterm group had higher rates of purulent meningitis, sepsis, and coagulation dysfunction, lower postoperative platelet counts, and lower intraoperative minimum body temperature than the term group (P<0.05). Conclusions There are significant differences in the clinical characteristics of preterm and term neonates with NEC undergoing surgery, suggesting the need for tailored perioperative management strategies based on these characteristics.