METHODS: A literature search was conducted in PubMed, Embase, and Web of Science databases for case-control studies exploring risk factors for NEC requiring surgical intervention. The search was completed on June 16, 2024, and data analysis was performed using R Studio 4.3.2.
RESULTS: 18 studies were included, comprising 1,104 cases in the surgery group and 1,686 in the medical treatment group. The meta-analysis indicated that high C-reactive protein (CRP) levels [OR = 1.42, 95% CI (1.01, 1.99)], lower gestational age [OR = 0.52, 95% CI (0.3, 0.91)], sepsis [OR = 2.94, 95% CI (1.87, 4.60)], coagulation disorder [OR = 3.45, 95% CI (1.81, 6.58)], lack of enteral feeding [OR = 3.18, 95% CI (1.37, 7.35)], and hyponatremia [OR = 1.22, 95% CI (1.07, 1.39)] are significant risk factors for surgical treatment in neonatal NEC.
CONCLUSIONS: High CRP levels, coagulation disorders, sepsis, lower gestational age, lack of enteral feeding, and hyponatremia are significant risk factors for surgical intervention in neonatal NEC. These findings have potential clinical significance for predicting surgical risk.
方法:在PubMed,Embase,和WebofScience数据库用于病例对照研究,探索需要手术干预的NEC的危险因素。搜索于2024年6月16日完成,使用RStudio4.3.2进行数据分析。
结果:纳入18项研究,手术组1104例,药物治疗组1686例。荟萃分析表明高C反应蛋白(CRP)水平[OR=1.42,95%CI(1.01,1.99)],低胎龄[OR=0.52,95%CI(0.3,0.91)],脓毒症[OR=2.94,95%CI(1.87,4.60)],凝血障碍[OR=3.45,95%CI(1.81,6.58)],缺乏肠内喂养[OR=3.18,95%CI(1.37,7.35)],低钠血症[OR=1.22,95%CI(1.07,1.39)]是新生儿NEC手术治疗的重要危险因素。
结论:高CRP水平,凝血障碍,脓毒症,较低的胎龄,缺乏肠内喂养,低钠血症是新生儿NEC手术干预的重要危险因素。这些发现对预测手术风险具有潜在的临床意义。