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目的:比较早产儿与足月儿新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)手术治疗的临床结果。方法:回顾性分析2014年1月至2018年12月湖南省儿童医院手术治疗的NEC患儿临床资料,根据胎龄分为早产儿组和足月儿组,比较两组一般情况、术前检查、术中所见、手术方式、术后并发症、术后死因和术后病死率。结果:共纳入126例NEC患儿,其中早产儿组67例,足月儿组59例。术前Bell分期Ⅱ期22例,Ⅲ期104例。早产儿组男性比例、双胎比例和手术日龄大于足月儿组,术前24 h内最近一次血气pH、外周血Hb和PLT低于足月儿组,差异均有统计学意义(n P<0.05)。术中所见早产儿组小肠坏死率高于足月儿组,结肠坏死率低于足月儿组,差异均有统计学意义(n P0.05)。NEC手术后早产儿组肠狭窄发生率低于足月儿组,差异有统计学意义(n P<0.05)。共死亡37例,病死率29.4%,早产儿组病死率(38.8%)高于足月儿组(18.6%),差异有统计学意义(n P0.05)。n 结论:早产NEC手术患儿男性和双胎比例高,手术日龄较大,小肠坏死多见,术后病死率较高;足月NEC手术患儿结肠坏死多见,术后容易出现结肠狭窄。“,”Objective:To compare the clinical results of surgical treatment of neonatal necrotizing enterocolitis (NEC) in preterm and term infants.Method:From January 2014 to December 2018, the clinical data of NEC infants receiving surgical treatment in our hospital was retrospectively analysed. The patients were assigned into premature group and full-term group according to gestational age. Their general conditions, preoperative examination results, intraoperative findings, surgical methods, postoperative complications, postoperative mortality rate and causes were compared between the two groups.Result:A total of 126 infants with NEC were enrolled, including 67 premature infants and 59 full-term infants. Before operation, 22 patients were in stage Ⅱ according to Bell grading for NEC and 104 patients in stage Ⅲ. The preterm group included more boys, more twins and later postnatal days receiving operation than full-term infants. The values of blood gas pH, peripheral blood Hb and PLT within 24 hours before surgery in preterm group were significantly lower than full-term group(n P<0.05). The intestinal necrosis rate in preterm group was higher than full-term group, and the colon necrosis rate was lower than full-term group, and the differences were statistically significant(n P0.05). The incidence of intestinal stenosis in the preterm group after NEC surgery was significantly lower than the full-term group(n P<0.05). A total of 37 patients died, with a mortality rate of 29.4%. The mortality rate in the preterm group (38.8%) was significantly higher than the full-term group (18.6%). Septicemia and septic shock were the most common causes of death in the two groups.n Conclusion:Compared with full-term infants, the proportions of male and twins in preterm NEC infants are higher, the operation age are older, and intestinal necrosis are more common, and the postoperative mortality rate is higher. Among full-term infants, colonic necrosis is common and colon stenosis is likely to occur after surgery.