新生儿坏死性小肠结肠炎手术时机研究新进展

Recent Progress in the Surgical Timing of Neonatal Necrotizing Enterocolitis

坏死性小肠结肠炎(NEC)发病率高、病情进展迅速、病死率高、后遗问题严重、内科保守治疗手段有限,对相当一部分病情严重和内科治疗无效的病例早期识别并及时进行手术干预可防止肠管发展为严重缺血坏死和随后的并发症,从而降低NEC的病死率并改善整体预后。但目前尚缺乏客观的临床手术指征体系。外科界对肠穿孔以外的NEC手术指征也远未达成共识。不同医疗机构或医生对于手术的决定及评估也主要凭临床经验,相对较为主观。故本文总结分析了近年来与NEC手术干预时机相关的文献。

Necrotizing enterocolitis (NEC) has a high incidence, rapid progression, high mortality, serious af-tereffects, and limited conservative medical treatment. Early identification and timely surgical in-tervention in a significant proportion of cases that are severe and do not respond to medical treat-ment can reduce mortality and improve the overall prognosis of NEC by preventing the develop-ment of severe isonecrosis and subsequent complications. However, there is still a lack of objective clinical surgical indication system. The surgical community is also far from consensus on the indica-tions for NEC beyond intestinal perforation. The decision and evaluation of surgery by different medical institutions or doctors are also mainly based on clinical experience, which is relatively sub-jective. Therefore, this paper summarizes and analyzes the literature related to the timing of NEC surgical intervention in recent years.