摘要
Abstract
Objective To establish a predictive model of necrotizing enterocolitis requiring surgical treatment in preterm infants with gestational age<34 weeks.Methods A total of 196 premature infants with gestational age<34 weeks and NEC during hospitalization were selected from the First Affiliated Hospital of Anhui Medical University from January 2016 to December 2023.They were divided into two groups according to different treatment methods.The children receiving surgical treatment were classified as operation group(n=47),and the children receiving conservative treatment were classified as non-operation group(n=149).Univariate and multivariate logistic regression were used to analyze the influencing factors requiring surgical treatment,and predictive model was established.Receiver operating characteristic(ROC)curve was used to evaluate the value of the nomogram model.Results There were significant differences in gestational age,birth weight,weight at onset,lymphocyte count(LC),neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP)and procalcitonin(PCT)levels within 24 h of onset between the two groups(P<0.05).Multivariate logistic regression analysis showed that birth weight(OR=0.997,95%CI:0.994-0.999),NLR(OR=1.356,95%CI:1.141-1.611),CRP(OR=1.016,95%CI:1.002-1.031)and PCT(OR=1.034,95%CI:1.007-1.062)were the influencing factors for surgical treatment of NEC in preterm infants with gestational age<34 weeks(P<0.05).R software was used to draw a column graph to predict the ROC curve of the risk of surgical treatment for NEC in premature infants with gestational age<34 weeks.The area under the curve was 0.835(95%CI:0.769-0.902),indicating that the model had good predictive value.Conclusion The lower the birth weight of preterm infants with gestational age<34 weeks and the higher the level of NLR,CRP and PCT within 24 h of the onset of NEC,the greater the risk of surgical treatment.As a simple and reliable prediction model,the nomogram can provide reference for clinical diagnosis and treatment.关键词
坏死性小肠结肠炎/早产儿/手术/预测模型Key words
Necrotizing enterocolitis/Preterm infant/Surgery/Predictive model分类
医药卫生
