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KMID : 0375219940090010133
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Journal of Il Sin Christian Hospital
1994 Volume.9 No. 1 p.133 ~ p.142
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A Clinical Observation of 23 cases of Necrotizing enterocolitis
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김옥영
정은주/김민정/서손상
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Abstract
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Purpose:
@EN We observed risk factors, clinical findings, diagnosis and treatment of NEC in 23 cases in order to try to prevent development of, and improve the prognosis of necrotizing enterocolitis9NEC0 I the future.
@ES Method:
@EN 23 cases of NEC who were admitted to the NICU of Il Sin Christian Hospital between Jan 1992 and June 1994 were studied. Data about birth weight, gestational age, risk factors, clinical findings, laboratory findings, radiologic findings,
treatment
and outcome were collected by review of medical records.
@ES Result:
@EN 1) Among the 23 cases of NEC, low birth weight was 21 cases(91.2%), and prematurity was 20 cases(87%).
2) clinically, abdominal distension was appeared in all cases. The next most frequently observed clinical finding was lethargy, then metabolic and then temperature instability.
3) On the plain abdominal X-rays of these cases, pneumatosis intestinalis was found in 15 cases(65.2%), followed by paralytic ileus, free air in the abdomen, portal vein gas, ascites and bowel wall edema in order.
4) On blood culture, microorganisms were grown in 5 cases(21.7%). There were Gram positive bacteria in 4 cases and anaerobe in 1 case.
5) According to Modified Bell's staging criteria, suspected NEC was 5 cases(21.7%), definite NEC was 10 cases(43.5%) and advanced NEC was 8 cases(34.8%), On blood culture, positive results was 1 case(10%) in definite NEC and 4 cases(50%) in
advanced
NEC. In advanced NEC, the mortality was 100%.
6) The overall mortality rate was 52.2% and the mortality rate among the 21 cases who were treated medically was 47.6%(10/21). The mortality rate among the 2 cases who were received an operation was 100%(2/2).
7) The causes of death were intestinal perforation associated with adhesions, pulmonary hemorrhage, prematurity and IRDS.
@ES Conculsion:
@EN As the diagnosis of NEC is very difficult and the mortality is high, newborn infants, particularly thoes who are born prematurely ro who have some of the associaed risk factors, must be closely observed in order to prevent its development.
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KEYWORD
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