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目的探讨重组人类促红细胞生成素(rhEpo)对早产儿坏死性小肠结肠炎(NEC)的预防作用。方法选择我院住院时间>2周的早产儿,常规预防早产儿贫血、接受rhEpo注射≥2周者为rhEpo组;未使用rhEpo或发生NEC以后才开始使用者为对照组;入院时已诊断NEC或其他胃肠道外科疾病者除外。对患儿易发生NEC的临床因素如窒息、呼吸窘迫综合征、呼吸机和肺表面活性物质的使用、动脉导管未闭和布洛芬的使用、小于胎龄儿、脐血管置管、先天性心脏病、脑室内出血、败血症与Ⅱ、Ⅲ级NEC的发生率进行回顾性分析。结果rhEpo组115例,对照组273例。rhEpo组呼吸窘迫综合征、呼吸机和肺表面活性物质的使用及脐血管置管的发生率均高于对照组(44%比26%,35%比19%,38%比14%,28%比4%,P均<0.05),而rhEpo组未发生NEC病例,对照组发生21例,其中Ⅱ级19例,Ⅲ级2例,两组总NEC和Ⅱ级NEC发生率,差异有统计学意义(P<0.05)。结论早产儿接受rhEpo预防和治疗贫血的同时,可能也保护了肠道,使其不发生NEC或减轻NEC的程度。
Objective To investigate the preventive effect of recombinant human erythropoietin (rhEpo) on necrotizing enterocolitis (NEC) in premature infants. Methods Preterm neonates with preterm infants who were hospitalized for> 2 weeks in our hospital were routinely prevented from anemia in preterm infants. Those who received rhEpo for 2 weeks or longer were enrolled as rhEpo group. Patients without rhEpo or NEC began to use as control group. NCD Or other gastrointestinal surgical diseases except. Clinical factors such as asphyxia, respiratory distress syndrome, ventilator and pulmonary surfactant, patent ductus arteriosus and ibuprofen in infants with NEC susceptibility, clinical data of less than gestational age, umbilical vascular catheterization, congenital heart disease Disease, intraventricular hemorrhage, sepsis and grade Ⅱ, Ⅲ NEC were retrospectively analyzed. Results 115 cases of rhEpo group, 273 cases of control group. Respiratory distress syndrome, ventilator and pulmonary surfactant use, and umbilical vascular catheterization were more common in the rhEpo group than in the control group (44% vs 26%, 35% vs 19%, 38% vs 14%, 28% P <0.05). However, there were no cases of NEC in rhEpo group and 21 cases in control group, of which 19 cases were grade Ⅱ and 2 cases were grade Ⅲ. The incidence of total NEC and grade Ⅱ NEC in both groups were statistically different Significance (P <0.05). Conclusions While preterm infants receiving rhEpo prevent and treat anemia, they may also protect the gut from developing NEC or reducing NEC.