Analyses of 164 cases neonatal necrotizing enterocolitis

2015 
Objective To explore the diagnosis, treatments and operative timing of neonatal necrotizing enterocolitis (NEC). Methods Retrospective analyses were conducted for the clinical data of 164 children of NEC. Results Among 72 surgical cases, 17 (23.61%) cases had an automatic discharge because of extensive bowel necrosis; among 41 (56.94%) cases of intestinal colostomy, 6/41(14.63%) had an automatic discharge. Because of too short proximal bowel for intestinal colostomy, 14 cases underwent direct anastomosis and 5/14 (35.71%) had an automatic discharge. Among 92 conservatively treated cases, 11/92 (11.95%) had an automatic discharge. The remaining 81 cases were cured and discharged. Because of intestinal stenosis, 5 cases with intestinal obstruction was readmitted for surgery. A total of 125(76.22%) cases were cured and 39 (23.78%) had an automatic discharge. Surgical cure was achieved for 44 cases with a curing rate of 61.11%. And, in the conservative group, 81 cases were cured with a curing rate of 88.04%. Conclusions NEC has a high mortality with a poor prognosis. For Bell stages I andⅡ NEC, conservative treatment is preferred. And early surgery is indicated for stage Ⅲ NEC. But it may not improve curing rate. Selecting an appropriate approach such as intestinal colostomy, anastomosis and enteral decompression should be based on the overall condition of bowel. Key words: Enterocolitis, necrotizing; Neonate; Surgical procedures, operative
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