Preterm bebeklerde nekrotizan enterokolit için risk faktörlerinin değerlendirilmesi
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Date
2011-03-02
Authors
Tayman, Cüneyt
Tonbul, Alparslan
Uras, Nurdan
Kahveci, Hasan
Köseoğlu, Burhan
Tatlı, M. Mansur
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Giriş: Bu çalışmada nekrotizan enterokolit (NEK) gelişiminde anne, bebek ve bebek bakımı ile ilişkili faktörlerin etkilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Doğum haftası ≤32 ve doğum ağırlığı ≤1500 gram olan hastalar çalışmaya dâhil edildi. Maternal demografik özellikler ve gebelik öyküsü, antenatal ve natal takipteki problemler, antenatal steroid tedavisi, doğum şekli (NVY, C/S), ve bebeğin doğum öyküsü kayıt edildi. NEK tanısından önce prematüre bebeğe uygulanan ventilasyon tedavisinin süresi ve transfüzyon sayıları kayıt edildi. Çalışmaya evre 2 ve evre 3 NEK olguları alındı. Bulgular: Beş yüz otuz iki hastadan 61’ine (%11,4) NEK tanısı konuldu ve çalışma grubu olarak belirlendi. 60 hasta kontrol grubu olarak seçildi. Çalışma ve kontrol grubu arasında demografik özellikler, APGAR skoru, resüsitasyon gereksinimi ve antenatal steroid kullanımı açısından farklılık bulunmadı. NEK’li hastalarda ventilatörde kalım süresinin (p=0,037) ve eritrosit süspansiyonu transfüzyon sıklığının daha fazla olduğu görüldü (p=0,032). Antenatal steroid kullanımının evre 2 NEK’li hastalarda daha fazla olduğu (p=0,011), evre 3 olanlarda ventilatörde kalım süresinin daha fazla olduğu bulundu (p=0,020). NEK’li hastalarda mortalite oranı %31,1 olarak saptandı. Ölen hastaların %84’ünde evre 3 NEK olduğu, doğum ağırlığı ve haftalarının daha düşük olduğu görüldü. NEK grubunda respiratuvar distress sendromu (RDS) (p=0,02); RDS ve patent duktus arteriosus (PDA) birlikteliği daha fazla olduğu (p=0,03), intrakranial kanamanın (‹KK) evre 3 NEK’te fazla olduğu (p=0,034) saptandı. Evre 3 NEK’li olgularda RDS, PDA ve ‹KK birlikteliği daha fazla bulundu (p=0,006). Evre 3 NEK’li hastaların annelerinde kronik hipertansiyon (p=0,003), eklampsi (p=0,034) ve infeksiyon (p=0,011) sıklığının fazla olduğu görüldü. Sonuç: Bu çalışmada antenatal, natal ve postnatal faktörlerin NEK gelişiminde önemli rol oynadığı gösterilmiş olup, bu faktörlere yönelik alınacak önlemlerle hastalığın sıklığının azaltılabileceği önerilmiştir.
Introduction: In the present study, it was aimed to evaluate the effects of the maternal and infantile factors and factors associated with the care of the infants in the development of necrotizing enterocolitis (NEC). Materials and Method: Infants with ≤32 weeks of gestational age and ≤1500 grams of birth weight were included in the study. Maternal demographic characteristics and pregnancy history, antenatal and postnatal follow-up problems, antenatal steroid treatment, modes of delivery (NVY, C/S), and the babies’ birth history were recorded. The duration of ventilation treatment and the number of transfusions applied before the diagnosis of NEC in premature infants were recorded. Patients with stage II and stage III NEC were included in the study. Results: Sixty one of 532 patients (11,4%) were diagnosed as NEC and allocated in the study group. Sixty patients were enrolled as the control group. There were no differences between both groups with respect to demographic characteristics, APGAR score, need for resuscitation and antenatal steroid treatment. The duration of ventilation treatment (p=0.037) and the frequency of red blood cell transfusion (p=0.032) were considered to be higher in the NEC group. Antenatal steroid administration was higher in patients with stage 2 NEC (p=0.011), but the duration of ventilation treatment was higher in those with stage 3 (p=0.020). The mortality rate was 31.1% in the patients with NEC. It was observed that 83% of patients who died had stage 3 NEC and a lower birth weight and gestational age. Respiratory distress syndrome (RDS) (p=0.02), togetherness of RDS and patent ductus arteriosus (PDA) were higher in the NEC group (p=0.03), and more intracranial hemorrhage (ICH) was detected at stage 3 NEC (p=0.034). RDS, PDA and ‹CH were frequently determined together in patients with stage 3 NEC (p=0.006). Chronic hypertension (p=0.003), eclampsia (p=0.034), and infection (p=0.011) were found to be more frequent in the mother of the patients with stage 3 NEC. Conclusion: In the present study, antenatal, natal and postnatal factors were shown to play an important role in the development of NEC, and if proposed measures to be taken, these factors may reduce the incidence of the disease.
Introduction: In the present study, it was aimed to evaluate the effects of the maternal and infantile factors and factors associated with the care of the infants in the development of necrotizing enterocolitis (NEC). Materials and Method: Infants with ≤32 weeks of gestational age and ≤1500 grams of birth weight were included in the study. Maternal demographic characteristics and pregnancy history, antenatal and postnatal follow-up problems, antenatal steroid treatment, modes of delivery (NVY, C/S), and the babies’ birth history were recorded. The duration of ventilation treatment and the number of transfusions applied before the diagnosis of NEC in premature infants were recorded. Patients with stage II and stage III NEC were included in the study. Results: Sixty one of 532 patients (11,4%) were diagnosed as NEC and allocated in the study group. Sixty patients were enrolled as the control group. There were no differences between both groups with respect to demographic characteristics, APGAR score, need for resuscitation and antenatal steroid treatment. The duration of ventilation treatment (p=0.037) and the frequency of red blood cell transfusion (p=0.032) were considered to be higher in the NEC group. Antenatal steroid administration was higher in patients with stage 2 NEC (p=0.011), but the duration of ventilation treatment was higher in those with stage 3 (p=0.020). The mortality rate was 31.1% in the patients with NEC. It was observed that 83% of patients who died had stage 3 NEC and a lower birth weight and gestational age. Respiratory distress syndrome (RDS) (p=0.02), togetherness of RDS and patent ductus arteriosus (PDA) were higher in the NEC group (p=0.03), and more intracranial hemorrhage (ICH) was detected at stage 3 NEC (p=0.034). RDS, PDA and ‹CH were frequently determined together in patients with stage 3 NEC (p=0.006). Chronic hypertension (p=0.003), eclampsia (p=0.034), and infection (p=0.011) were found to be more frequent in the mother of the patients with stage 3 NEC. Conclusion: In the present study, antenatal, natal and postnatal factors were shown to play an important role in the development of NEC, and if proposed measures to be taken, these factors may reduce the incidence of the disease.
Description
Keywords
Nekrotizan enterokolit, Prematüre, Risk faktör, Yenidoğan, Necrotizing enterocolitis, Prematurity, Risk factor, Newborn
Citation
Tayman, C. vd. (2011). "Preterm bebeklerde nekrotizan enterokolit için risk faktörlerinin değerlendirilmesi". Güncel Pediatri, 9(1), 7-13.