Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years


Autoři: Lu Lin aff001;  Xuhua Xia aff001;  Wei Liu aff002;  Yongming Wang aff001;  Ziyu Hua aff001
Působiště autorů: Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, P.R China aff001;  National Clinical Research Center for Child Health and Disorders, Chongqing, P.R China aff002;  China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, P.R China aff003;  Department of Gastrointestinal and Neonatal Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, P.R China aff004;  Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, P.R China aff005;  Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, P.R China aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224880

Souhrn

The aim of this retrospective study was to explore the risk factors and clinical characteristics related to neonatal fulminant necrotizing enterocolitis (NEC). From 1 November 2007 to 31 October 2017, 352 neonates who were diagnosed with NEC (Bell stage ≥ΠB) and admitted to the Children’s Hospital of Chongqing Medical University were enrolled. Among these patients, 112 (31.82%) cases fulfilled the definition of fulminant NEC, and 62.5% (70/112) of fulminant cases presented a poor prognosis. All the survivors in the fulminant NEC group underwent surgery. Those in the fulminant NEC group were more likely to have the following clinical features: sepsis preceding NEC (P<0.001), abdominal distention (P<0.001), bowel sound disappearance (P = 0.001), leukopenia or neutropenia (P<0.001), C-reactive protein (CRP) <10 mg/L (P = 0.003), procalcitonin (PCT) < 2 μg/L (P<0.001), pH ≤7.2 (P<0.001), and radiographic evidence of pneumoperitoneum (P<0.001) or seroperitoneum on ultrasonography (P = 0.017). In conclusion, fulminant NEC is characterized by urgent onset and prompt deterioration, potentially resulting in death. The lack of unique characteristics makes it difficult to recognize by medical caregivers. Close observation, early detection and timely surgical intervention may improve the prognosis.

Klíčová slova:

Birth weight – Blood – Gastrointestinal tract – Infants – Neonates – Pediatrics – Prognosis – Surgical and invasive medical procedures


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Článek vyšel v časopise

PLOS One


2019 Číslo 11