ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ VIÊM RUỘT HOẠI TỬ Ở TRẺ SƠ SINH NON THÁNG TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ

Abstract

  Background: Necrotizing enterocolitis (NEC) is one of the most severe gastrointestinal complications in preterm neonates, particularly among extremely preterm infants. Although advances in neonatal intensive care have significantly improved survival rates in this vulnerable population, NEC remains a major cause of mortality and prolonged hospitalization. The disease continues to pose substantial clinical challenges due to its unpredictable course and serious short- and long-term consequences. Objectives: To describe the clinical and paraclinical characteristics and evaluate the treatment outcomes of NEC in preterm neonates at Can Tho Children's Hospital. Materials and methods: A case series study was conducted on 33 preterm neonates diagnosed with NEC (Modified Bell’s stage > II). Results: Males accounted for 66.7%. The median gestational age was 30 weeks, and the median birth weight was 1300g. Dominant risk factors included umbilical catheterization (90.9%) and respiratory distress syndrome (51.5%). Early onset was observed with a median of 3 days. Clinical manifestations were dominated by respiratory failure (84.8%) and abdominal distension (81.8%). Abdominal ultrasound detected pneumatosis intestinalis in 57.6% of cases, demonstrating significantly higher sensitivity than X-ray (9.1%). Most patients were classified as Stage IIA (60.6%) and IIB (33.3%). The mortality rate was 39.4%, primarily associated with multi-organ failure (36.4%). Conclusions: NEC predominantly affects very preterm and very low birth weight infants with early onset and severe systemic involvement. Abdominal ultrasound is crucial for early diagnosis. Despite intensive care, the mortality rate remains substantial.