Yenidoğan Yoğun Bakım Ünitesindeki Bebeklerin Nekrotize Enterokolit Risk Faktörlerinin Karşılaştırılması

Abstract

Purpose: Necrotizing enterocolitis is one of the important problems of premature infants. The incidence is about 1-5% in infants followed in neonatal care units and inversely related to gestational age and birth weight. Materials and Methods: In this study, 31 infants with necrotizing enterocolitis and 31 infants with similar gestational age and birth weight as control group hospitalized in Cukurova University Neonatal Care Unit between 1 January 2001-31 January 2004 were evaluated. Results: The incidence of necrotizing enterocolitis in this period was 1.4 (31/2214 admission). Mean gestational age was 30.5  3.2 weeks (25-36), mean birth weight was 1331  384 (730-2150) grams while 71% was younger than 32 gestational weeks and 67.7% was under 1500 grams. The signs of NEC were detected at a mean of 11.2  10. (2-38) days. Twenty-six (83.9%) were being fed at the time of the necrotizing enterocolitis signs appeared. According to the Walsh and Kliegman classification, 19 (61.3%) infants were in stage 1 (17 were 1a, 2 were 1b); 3 (9.6%) infants were in stage 2a, 9 (%29.1) infants were in stage 3 (7 were in 3b). Blood culture was positive in 7 (%22.6) infants with predominance of gram negative microorganisms (5 infants). Eleven (%35.5) infants were exitus, 12 were discharged. Hypoxia, respiratory distress syndrome, intraventricular hemorrhage and umbilical catheterization were significant risk factors in necrotizing enterocolitis . Thrombocytopenia, leucopenia and high C-reactive protein levels were significantly high in necrotizing enterocolitis group. Breast feeding is significantly high in control group. Conclusion: Necrotizing enterocolitis, is a leading cause of morbidity and mortality in neonatal intensive care units. Early breast feeding with small amounts, increasing amount of milk slowly, antenatal steroids, caring hygiene rules can prevent the development of it.