Abstract：
Necrotizing enterocolitis (NEC) increases morbidity and mortality for infants with single ventricle heart disease (SVHD). While hematochezia often proceeds NEC not all hematochezia progresses to NEC. We aimed to examine the incidence, risk-factors, and outcomes associated with hematochezia and NEC for infants with SVHD. A single-center cohort study including SVHD patients requiring Stage I palliation from 12/2010 to 12/2015 was performed. Demographic, clinical, and outcome measures during the interstage period were abstracted from medical records. We defined hematochezia as blood in the stool without alternative etiology and NEC as systemic or intestinal signs concurrent with hematochezia and/or the presence of radiographic pneumatosis. Clinical characteristics and outcome measures were compared between patients with/without hematochezia and with/without NEC. Of 135 patients, 59(44%) had hematochezia and 20(15%) developed NEC. Demographic and operative factors were similar between patients with and without hematochezia. Patients with NEC were more often premature (15% vs 0%, p = 0.04), have lower birth weight (3.0 ± 0.6 vs 3.3 ± 0.5 kg, p = 0.03), longer cardiopulmonary bypass time (median 131 vs. 90 min, p = 0.02) and more often underwent unplanned cardiac catheterization (20% vs 3%, p = 0.04). Patients with hematochezia had more line days (p < 0.0001) and longer post-Stage-I length of stay (p < 0.0001) than those without hematochezia, and those with NEC had more line days than those without NEC (p = 0.02). Hematochezia is frequent following Stage-I palliation, however only one third of these patients develop NEC. Non-NEC Hematochezia is associated with a similar increase in line and hospital days. Further research is needed to identify methods to avoid over treatment.
摘要：
坏死性小肠结肠炎（NEC）会增加单心室心脏病（SVHD）婴儿的发病率和死亡率。虽然便血经常进行NEC，但并非所有便血都会发展为NEC。我们的目的是检查发病率，风险因素，以及与SVHD婴儿便血和NEC相关的结局。进行了一项单中心队列研究，包括2010年12月至2015年12月需要I期缓解的SVHD患者。人口统计,临床,并且从医疗记录中提取了阶段间期间的结局指标。我们将便血定义为没有其他病因的粪便中的血液，将NEC定义为伴有便血和/或影像学肺炎的全身或肠道体征。比较了有/没有便血和有/没有NEC的患者的临床特征和结局指标。135名患者中,59（44％）患有便血，20（15％）患有NEC。有和没有便血的患者的人口统计学和手术因素相似。NEC患者更容易早产（15%vs0%，p=0.04),出生体重较低(3.0±0.6vs3.3±0.5公斤，p=0.03),更长的体外循环时间（中位数131vs.90分钟,p=0.02），并且更经常进行非计划心导管插入术（20％vs3％，p=0.04)。与没有便血的患者相比，便血患者的线天数更多（p<0.0001）和I期后住院时间更长（p<0.0001），那些有NEC的人比没有NEC的人有更多的线日(p=0.02)。在I期缓解后便血频繁出现，然而，这些患者中只有三分之一发展为NEC。非NEC便血与线路和住院天数的类似增加有关。需要进一步的研究来确定避免过度治疗的方法。
