中国实用儿科杂志

中国实用儿科杂志 ›› 2024, Vol. 39 ›› Issue (5): 350-355.DOI: 10.19538/j.ek2024050608

• 专题笔谈 • 上一篇    下一篇

新生儿坏死性小肠结肠炎手术指征的临床思考

  

  1. 国家区域儿童医学中心（东北）  中国医科大学附属盛京医院儿外科，辽宁  沈阳  110003
  • 出版日期:2024-05-06 发布日期:2024-05-09
  • 通讯作者: 张志波，电子信箱：zhangzb@sj-hospotal.org

Clinical reflection on the surgical indications of NEC

  1. Department of Pediatric Surgery，Shengjing Hospital of China Medical University，National regional Center （Northeast） for Children’s Health，Shenyang  110003，China. 
  • Online:2024-05-06 Published:2024-05-09

摘要： 坏死性小肠结肠炎（necrotizing enterocolitis，NEC）是新生儿期特有的累及回肠及结肠的肠道炎症坏死性疾病，主要发生于低出生体重早产儿，其临床症状及体征进展迅速，是严重威胁早产儿生存的常见疾病之一。内科保守治疗措施为胃肠道休息、应用抗生素、对症处理并发症等，部分病例因保守治疗无效或疾病进展而需要手术治疗，理想的外科手术时机、手术指征及手术方式目前尚无定论。该文通过临床外科治疗的思考，探讨NEC手术干预时机、手术方式的选择，旨在提高NEC患儿的生存率。

关键词: 坏死性小肠结肠炎, 新生儿, 手术指征, 手术方式

Abstract: Necrotizing enterocolitis （NEC） is an inflammatory necrotizing disease of the intestinal tract involving the ileum and colon，which mainly occurs in low birth weight preterm infants. NEC often progresses rapidly and remains one of the most common diseases that seriously threaten the lives of preterm babies. Generally，NEC is first treated medically and conservatively，including intestinal rest application of antibiotics，and management of complications，etc. However，some cases still progress rapidly despite the most aggressive medical treatment and eventually need to be operated on. The ideal surgical opportunity，indications，and methods are still inconclusive，which will be further discussed in this paper on the basis of our clinical experience，with the purpose of improving the survival of NEC infants.

Key words: necrotizing enterocolitis, neonate, surgical indications, surgical methods