PDF(Pubmed)
Abstract：
BACKGROUND: Necrotizing enterocolitis (NEC) is a complex disease characterized by gastrointestinal inflammation and is one of the most common gastrointestinal emergencies in neonates. Mild to moderate cases of NEC require medical treatment, whereas severe cases necessitate surgical intervention. However, evidence for surgical indications is limited and largely dependent on the surgeon\'s experience, leading to variability in outcomes. The primary aim of this study is to identify the risk factors for surgical intervention in neonatal NEC, which will aid in predicting the optimal timing for surgical intervention.
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.
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.
摘要：
背景：坏死性小肠结肠炎（NEC）是一种以胃肠道炎症为特征的复杂疾病，是新生儿最常见的胃肠道急症之一。轻度至中度NEC病例需要治疗，而严重的病例需要手术干预。然而,手术适应症的证据是有限的，很大程度上取决于外科医生的经验，导致结果的可变性。这项研究的主要目的是确定新生儿NEC手术干预的危险因素，这将有助于预测手术干预的最佳时机。
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。
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。
