CLINICAL EXPERIENCE OF DIAGNOSTICS OF THE SURGICAL STAGE AND TREATMENT TACTICS FOR NECROTIZING ENTEROCOLITIS IN NEWBORNS

This research article presents treatment outcomes of 30 newborns for necrotizing enterocolitis (NEC) in the Surgical Ward of the Pediatric Center, Republic’s Hospital No. 1 - National Center of Medicine in the period 2005-2018. A retrospective chart review was conducted, where the reviewed data of gestation course and childbirth, risk factors for the development of this disease were considered: birth deformity, dietary pattern, clinical data, laboratory, instrumental and radiological methods of investigation before the manifestation of necrotizing enterocolitis, timing of diagnosis, types of surgical treatment performed, tactics of antibiotic therapy, studied the results and fate of treatment. We describe the clinical experience and therapeutic tactics for this pathology. The main risk factors of the disease were established, for which statistical data analysis was performed using the online program medcalc.net (“https://www.medcalc.net/”) and “STATISTICA 13.3. EN” (“StatSoft Russia”), where we determined the normal type of distribution of results and conducted tests for the presence of a significant difference in the subgroups: gestational age with a favorable outcome (G1), gestational age with mortality (G2), and birth weight with a favorable outcome (M1) and birth weight with mortality (M2). The analysis of the conformity of the type of distribution of features to the law of normal distribution was carried out using the Shapiro-Wilk W test; Student’s t-test was used to assess the differences between the groups. It was statistically established that there is a direct relationship between gestational age, birth weight and disease outcome. Based on the data obtained, it is possible to predict the further course of the disease and change the protocol for treating patients. This tactic allowed improving the results of treatment of necrotic enterocolitis in newborns and reducing the mortality of this pathology by two times.

newborn, premature children, necrotizing enterocolitis, risk factors, diagnosis, treatment

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