THE TREATMENT NECROTISING ENTEROCOLITIS IN NEWBORNS

Abstract

lively discussion. The results of treatment of 24 newborns with NEC, who were in the Aktobe medical center in the period 2015-2017. A positive result was obtained in 2 children after conservative therapy. In 22 cases, children entered the III-IV stages of NEC. 15 children underwent laparocentesis and drainage of the abdominal cavity at the stage of preoperative preparation. In 7 cases laparocentesis was not performed. 21 children with NEC underwent surgical treatment in different periods of inpatient treatment. Laparoscopy was performed in 1 child, laparotomy in 20 children. Mortality rate was 41.6%. Postoperative lethality 42,8%. High mortality was observed in a group of premature babies with concomitant pathology of other organs. The number of patients with NEC with a very low body weight has increased. Mandatory laparocentesis with drainage of the abdominal cavity in the preoperative period positively affects the results of treatment. The early initiation of treatment by neonatologists in the pediatric stage of NEC leads to a disruption in the staging of the disease, to a distortion of the pattern of intra-abdominal catastrophe, especially when infiltrative-adhesive forms of necrotic enterocolitis with a subacute course of the disease. Deferred surgical treatment leads to the spread of the process and an unfavorable outcome. Necrotic changes in the primary parts of the jejunum compel the surgeon to form high stoms. The formation of magneto-compression anastomoses in the postoperative period would help in solving the problem of early closure with anjejunostoms. The analysis of the results of treatment corresponds to the results of a large number of scientific works and shows the changes that have occurred in recent years in the clinic and the diagnosis of necrotizing enterocolitis.