Abstract | Uvod/cilj: Nekrotizirajući enterokolitis jedna je od najčešćih gastrointestinalnih hitnoća novorođenčadi, čija se pojava veže uz prematurno rođenu djecu, te unatoč ranoj dijagnostici i agresivnoj terapiji, bilježi visoku smrtnost. Cilj ovog rada je uočiti utjecaj određenih parametara na ishod bolesti. Bolesnici i metode:u istraživanje su uključena sva djeca, koja su u razdoblju od 2013.-2018., liječena na Klinici za pedijatriju KBC-a Rijeka, zbog NEK-a. Bilježili smo određene parametre: rodna težina, gestacijska dob, cirkulacijske nestabilnosti, empirijska antibiotska terapija i njeno trajanje, simptomi, perforacija, terapija, prijeoperativna prehrana, radiografski nalazi, uporaba probiotika, sepsa, acidoza, anemija, , KKS, DKS, te pratili utjecaj navedenih na ishod bolesti. Rezultati: analizirano je ukupno 17 pacijenata s NEK-om. 70% djece rođeno je između 25.-30. tjedna gestacije, 65% pripada kategoriji ELBW. 47% nema vidljivih radioloških nalaza, a 65% imalo je perforaciju. Od njih je 53% liječeno operativno-laparotomija. Majčino mlijeko konzumiralo je 17% pacijenata, a mliječnu formulu 65%. Cirkulacijske nestabilnosti imalo je 76,5%, a transfuziju eritrocita primilo također toliko. Zaključak: statističkom obradom utvrđena je pozitivna korelacija rodne težine i gestacijske dobi s ishodom bolesti, kao i negativna korelacija cirkulacijskih nestabilnosti i transfuzije krvnih pripravaka. Sve korelacije su statistički značajne. Utjecaj majčinog mlijeka, vjerojatno bi bio statistički značajan, na većem broju pacijenata. Stoga, potrebna su daljnja istraživanja na većem uzorku uz dostupnost svih podataka. |
Abstract (english) | Introduction: Necrotizing enterocolitis is one of the most common gastrointestinal emergencies in newborns, usually manifested in premature infants and, despite an early diagnosis and an aggressive therapy, high mortality is being reported. The aim of this paper is to observe the influence of certain parameters on the outcome of this disease. Patients and methods: All children treated for NEC from 2013 to 2018, at the Pediatric Clinic of KBC Rijeka, are included in the study. Certain parameters like: birth weight, gestational age, circulatory instabilities, empirical antibiotic therapies and the duration, symptoms, perforation, therapies, preoperative nutrition, radiographic findings, probiotic usage, sepsis, acidosis, anemia, CBC, WBCC, have been recorded. The impact of the mentioned parameters on the disease has been monitored. Results: A total of 17 patients with NEC were analyzed. 70% of children were born between the 25th and the 30th week of gestation, 65% of them belong to the ELBW category. 47% had no visible radiological findings, and 65% had perforation. 53% of them were treated with the operative laparotomy. Breast feeding was consumed by 17%, and milk formula by 65%of patients. Circulation instability was noticed in 76.5%, and erythrocyte transfusion was recieved by the same percentage of patients. Conclusion: statistical analysis determined the positive correlation of birth weight and gestational age with the outcome of the disease, as well as the negative correlation of circulatory instability and transfusion of blood products. All correlations are statistically significant. Influence of breast milk would probably be statistically significant if a larger number of patients was analyzed. Therefore, further research with the availability of all the data on a larger sample size is needed. |