introduzione l'enterocolite necrotizzante è la principale emergenza chirurgica neonatale. lo scopo di questo studio è di valutare il ruolo del drenaggio addominale preventivo sull'evoluzione clinica materiali e metodi sono stati arruolati con randomizzazione i pazienti con NEC allo stadio 2 e trattati con drenaggio addominale o classicamente riultati i pazienti trattati con drenaggio preventivo hanno sviluppato minor complicanze rispetto al trattamento classico discussione il drenaggio preventivo riesce a detendere l'addome e creare quindi una miglior complicance che garantisce una miglior vascolarizzazione delle anse intestinali

After the birth and development of Neonatal Intensive Care, necrotizing enterocolitis (NEC) has become the most common perinatal gastrointestinal emergency.The aim of this trial is to find out risk and predictive factors of NEC development, to identify prognostic factors on patients’ survival as well as, and most of all, to identify the preventive role of the peritoneal drain. materials and methods There are TWO study groups: Group A: placement of abdominal drainage in stage 2; Group B: surgical treatment only with perforation (plus retrospective data for each study centre)(patients treated with PD on stage III are included). results: When comparing NEC with non-NEC group, there was a significant difference between Apgar score at 1 minute (2±1 vs. 4±1 respectively, p<0.05) but not for Apgar at 5 minutes (p>0.05). The use of prenatal steroids was associated with lower mortality rate and lower NEC stage (p<0.05). Patients who received bowel enemas starting from day 2 after birth did not developed NEC or advanced NEC (p<0.05). If compared to our previous data, only 13 infants out of 58 (22%) developed advanced NEC(stage III)(p<0.05): Nine infants from the NEC group and seven infants from the non NEC group died. Only 20% of patients treated with PPD underwent laparotomy for bowel perforation (p<0.05). discussion abdominal drain is safe and could be considred an alternative treatment

Necrotizing enterocolitis in infants: risk factors and clinical outcomes. The role of peritoneal drainage in Bell’s Stage 2

ZAMPIERI, Nicola
2011-01-01

Abstract

After the birth and development of Neonatal Intensive Care, necrotizing enterocolitis (NEC) has become the most common perinatal gastrointestinal emergency.The aim of this trial is to find out risk and predictive factors of NEC development, to identify prognostic factors on patients’ survival as well as, and most of all, to identify the preventive role of the peritoneal drain. materials and methods There are TWO study groups: Group A: placement of abdominal drainage in stage 2; Group B: surgical treatment only with perforation (plus retrospective data for each study centre)(patients treated with PD on stage III are included). results: When comparing NEC with non-NEC group, there was a significant difference between Apgar score at 1 minute (2±1 vs. 4±1 respectively, p<0.05) but not for Apgar at 5 minutes (p>0.05). The use of prenatal steroids was associated with lower mortality rate and lower NEC stage (p<0.05). Patients who received bowel enemas starting from day 2 after birth did not developed NEC or advanced NEC (p<0.05). If compared to our previous data, only 13 infants out of 58 (22%) developed advanced NEC(stage III)(p<0.05): Nine infants from the NEC group and seven infants from the non NEC group died. Only 20% of patients treated with PPD underwent laparotomy for bowel perforation (p<0.05). discussion abdominal drain is safe and could be considred an alternative treatment
2011
necrotizing enterocolitis, infants, treatment
introduzione l'enterocolite necrotizzante è la principale emergenza chirurgica neonatale. lo scopo di questo studio è di valutare il ruolo del drenaggio addominale preventivo sull'evoluzione clinica materiali e metodi sono stati arruolati con randomizzazione i pazienti con NEC allo stadio 2 e trattati con drenaggio addominale o classicamente riultati i pazienti trattati con drenaggio preventivo hanno sviluppato minor complicanze rispetto al trattamento classico discussione il drenaggio preventivo riesce a detendere l'addome e creare quindi una miglior complicance che garantisce una miglior vascolarizzazione delle anse intestinali
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/378262
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