源于新生儿坏死性小肠结肠炎的败血症研究进展

Progress of research in neonatal sepsis from necrotizing enterocolitis

新生儿坏死性小肠结肠炎(NEC)是新生儿时期严重的胃肠道疾病之一,病死率较高。研究表明NEC可并发肠源性败血症,且与高病死率有关,故积极探寻NEC导致败血症发生的相关因素及防治措施,对改善NEC患儿预后有重要意义。近年来研究表明,NEC导致败血症的主要危险因素包括早产与低出生体质量、需要长时间静脉营养、抗生素使用时间过长;主要的病原菌为革兰阴性杆菌;通过补充益生菌、谷氨酰胺、乳铁蛋白能够降低NEC发病率及严重程度,可能有助于进一步减少肠源性败血症的风险。

Necrotizing enterocolitis（NEC） is one of the severe gastrointestinal emergencies with high mortality in neonatal period. Studies suggested that sepsis from NEC were associated with higher mortality in NEC. Therefore, it is important to explore the related factors and prevention measures of NEC and improve the prognosis of children with NEC. In recent years, studies have shown that the risk factors of sepsis in NEC included prematurity, low birth weight, long time of total parenteral nutrition supports and long duration of antibiotic exposure. The main pathogen of sepsis was gram-negative bacilli. Probiotics, glutamine and lactoferrin supplementation may reduce the incidence and severity of NEC, and may help further reduce the risk of gut-derived sepsis.