Nekrotizan Enterokolitli Prematüre Bebeklerin Değerlendirilmesi

Year 2010, Volume: 8 Issue: 3, 56 - 62, 01.12.2010

Hilal Özkan Merih Çetinkaya , Nilgün Köksal Evren Özboyacı Ali Özboyacı Şenay Yapıcı

Abstract

Giriş: Bu çalışmanın amacı yenidoğan yoğun bakım ünitesinde nekrotizan enterokolit NEK ile izlenmiş olan prematüre bebeklerin karakteristik özellikleriyle kısa ve uzundönem sonuçlarının değerlendirilmesidir.Gereç ve Yöntem: Çalışmaya Ocak 2005 ile Aralık 2009 yılları arasında yenidoğan yoğunbakım ünitemizde yatarak takip edilen gestasyon yaşı ≤34 hafta olan ve NEK tanısı alan50 prematüre bebek alındı ve bu bebeklerin karakteristik özellikleri, klinik ve laboratuvarbulguları ve prognozları değerlendirildi.Bulgular: Çalışmaya alınan prematüre bebeklerin 15’inde %30 evre 1, 21 %42 tanesinde evre 2 ve 14 %28 tanesinde evre 3 NEK mevcuttu. NEK insidansı %7,5 50/658 idi. NEK gelişen bebeklerin ortalama gestasyon yaşlarının ve doğum ağırlıklarının,sırasıyla 29±2,2 hafta ve 1142±300 gram olduğu görüldü. Ortalama NEK başlangıç zamanı18,5±8,1 gün idi. Olguların %64’ünde hipoksik doğum öyküsünün olduğu saptandı ve annesütü ile beslenme oranı %54 olarak bulundu. NEK’li olguların %36’sında kan kültüründeüreme tespit edildi. Evre 3 NEK olan 8 olguda cerrahi tedavi uygulanırken diğer olgularmedikal tedaviye cevap verdi. Mortalite oranı %12 olarak bulundu ve yaşayan bebeklerdekısa ve uzun dönem en sık sorunların sırası ile beslenme problemleri ve malabsorbsiyonolduğu görüldü.Sonuç: NEK prematüre bebeklerde görülen en ciddi sorunlardan biridir. Yenidoğanyoğun bakımındaki gelişmelerle mortalitesi ve sıklığı azaltılabilmiştir. Etyolojide yer alanen önemli faktörler prematürite, hipoksi ve enteral beslenmedir

Keywords

Prematürite, nekrotizan enterokolit, prognoz

Evaluation of Premature Newborns with Necrotizing Enterocolitis

Abstract

Introduction: The aim of this study was to evaluate the characteristic features and bothearly and late term prognosis of premature infants who were followed-up with NEC inthe neonatal intensive care unit. Materials and Method: A total of 50 premature infants less than 34 gestational weekswith NEC between January 2005 and December 2009 were included to this study and thecharacteristic features, clinical and laboratory findings, and prognosis of these infantswere evaluated.Results: In this study, 15 infants 30% had stage 1, 21 infants 42% had stage 2 and 14infants 28% had stage 3 NEC. The incidence of NEC was 7.5% 20/568 . The mean gestational age and birth weight of infants who developed NEC were 29±2.2 weeks and1142±300 grams, respectively. The mean onset of NEC was 18.5±8.1 days. There washypoxic birth history in 64% of infants and the ratio of breastfed infants was 54%. Therewas a positive blood culture in 36% of infants with NEC. Surgery was performed in 8infants with stage 3 NEC, whereas the other infants responded well to medical treatment. The mortality rate was 12% and feeding problems and malabsorption werefound to be the most common early and late term problems in infants who survived. Conclusions: NEC is one of the serious problems in premature infants. The mortality andfrequency of NEC was decreased with the improvements in the Neonatal Intensive Care.The most important etiological factors were prematurity, hypoxia and enteral feeding

Keywords

Prematurity, necrotizing enterocolitis, prognosis

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