新生儿坏死性小肠结肠炎研究进展

Research advances in necrotizing enterocolitis in neonates

坏死性小肠结肠炎(NEC)是由多种因素导致的新生儿,尤其是早产儿的灾难性疾病。严重的NEC病死率高,幸存者多面临短期及长期不良预后。与NEC有关的危险因素包括早产、非母乳喂养、消化道内微生物异常、缺血再灌注损伤等。高分辨腹腔超声检查有助于NEC的早期诊断。通过营养干预保护肠黏膜、干扰肠道损伤信号、改变肠道微生态环境及早期微量喂养有助于预防NEC。该病进展迅速,目前尚无有效措施,以支持治疗为主,严重者需外科治疗,雷公藤红素、脂多糖结合蛋白、粪便移植可能有助于治疗NEC,但仍有待于进一步研究。

Necrotizing enterocolitis（NEC） is a catastrophic disease caused by a variety of factors in neonates, especially preterm infants. Severe NEC has a high fatality rate, and most survivors may face short-and long-term adverse prognosis. Risk factors for NEC include preterm birth, non-breastfeeding, microbial abnormalities in the digestive tract, and ischemia-reperfusion injury. High-resolution abdominal ultrasound helps with the early diagnosis of NEC. The preventive measures for NEC include protecting the intestinal mucosa through nutritional intervention, interfering with intestinal injury signals, changing intestinal microflora, and performing early minimal enteral nutrition. This disease progresses rapidly, and there are still no effective measures. Supportive care is mainly used for the treatment of this disease, and patients in severe conditions may need surgical treatment. Celastrol, lipopolysaccharide, and fecal transplantation help with the treatment of NEC, but further studies are needed to confirm their clinical effects.