Analysis of influencing factors of intestinal failure associated liver disease after enterostomy in neonatal necrotizing enterocolitis
Li Guang, Zhang Yanping, Zhang Yingna, et al
Beijing Key Laboratory of Pediatric Organ Failure, National Engineering Laboratory for Birth defects prevention and control of key technology, Institute of Pediatrics, the Seventh Medical Center of PLA General Hospital, Faculty of Pediatrics, the Chinese PLA General Hospital, Beijing 100700, China
Abstract: 【Abstract】 Objective To analyze the influencing factors and interventions of intestinal failure associated liver disease (IFALD) fistula after enterostomy in neonatal necrotizing enterocolitis (NEC). Method FromJanuary 1, 2018 to January 31, 2022, 78 neonates with NEC who underwent enterostomy and repaymentsurgery in the Seventh Medical Center of PLA General Hospital were selected as the research objects by aretrospective study method. According to the presence or absence of IFALD, the children were divided intothe non-IFALD group (n=51) and the IFALD group (n=27). The clinical data of the two groups were analyzed,and the related factors of IFALD after operation were analyzed. Chi-square test, t-test and multivariateLogistic regression were used for statistical analysis. Result The proportion of preterm infants in theIFALD group and the non-IFALD group were [92.6% (25/27) vs 72.5% (37/51), χ2=4.084, P=0.043],respectively; the proportion of low birth weight infants were [88.9% (24/27) vs 70.6% (36/51), χ2=4.722,P=0.030], respectively; the proportion of residual small intestine length <40 cm after enterostomy were [37.0%(10/27) vs 11.8% (6/51), χ2=7.456, P=0.039], respectively; the incidence of sepsis was [37.0% (10/27) vs5.9% (3/51), χ2=12.764, P=0.001]; Which in the IFALD group were all higher than those in the non-IFALDgroup, and the difference were statistically significant. The days of postoperative lactation in IFALD groupand non-IFALD group were [(10±5) vs (9±4) d, t=-1.241, P=0.021], respectively. The number of daysneeded to reach whole intestinal feeding were [(50±19) vs (27±13) d, t=3.341, P<0.001], respectively; andthe IFALD group was all longer than the non-IFALD group, and the difference were statistically significant.Multivariate Logistic analysis showed that the number of days to complete enteral feeding was positivelycorrelated with the occurrence of IFALD (OR=1.075, P=0.001). Sepsis was positively correlated with IFALD(OR=5.427, P=0.027). Conclusion The children with NEC after enterostomy should be fed as soon aspossible when their condition is stable, and actively prevent infection are important factors to improvethe outcome of IFALD.
2022, Vol. 10 
