Liang Qionghe,Jiang Weiwei,Lu Changgui,et al.Clinical characteristics of Necrotizing enterocolitis after neonatal intestinal surgery[J].Journal of Clinical Pediatric Surgery,,18():372-375.[doi:10.3969/j.issn.1671-6353.2019.05.007]
Clinical characteristics of Necrotizing enterocolitis after neonatal intestinal surgery
- Keywords:
- Intestines; Small/SU; Colorectal Surgery; Enterocolitis; Necrotizing/CO; Infant; Newborn
- CLC:
- R722.1;R574.62
- Abstract:
- Objective To explore the clinical features and causes of necrotizing enterocolitis (NEC) after neonatal intestinal surgery and explore its early diagnosis and treatment experience.Methods A retrospective analysis was conducted for 6 hospitalized NEC children after intestinal surgery from September 2011 to November 2016.Their clinical manifestations,treatments and outcomes were analyzed for formulating treatment options for preventing NEC after neonatal intestinal surgery.Results There were abdominal distension (n=5),melena (n=5),diarrhea (n=2),fever,hematemesis & anorexia (n=1) and shock (n=3).And Bell stages were Ⅱ (n=2) and Ⅲ (n=4).Four cases of conservative treatment were successful.After 1-week conservative treatment,abdominal distension and melena improved.However,intestinal obstruction was cured after loosening intestinal adhesion.One case of conservative treatment improved in acute phase and surgery was performed after 3 months due to ascending colon stenosis.Conclusion In events of such symptoms as melena,abdominal distension,diarrhea,anorexia and fever after intestinal surgery,clinicians should stay on a high alert for the occurrence of NEC.Intervention should be performed as soon as possible and most cases may be cured conservatively.
References:
1 Goudoever HV,陈超,张蓉.新生儿坏死性小肠结肠炎的热点问题[J].中国循证儿科杂志,2011,6(5):321-323.DOI:10.3969/j.issn.1673-5501.2011.05.001.Goudoever HV,Chen Chao,Zhang Rong.Hot issues of neonatal necrotizing enterocolitis[J].Chinese Journal of Evidence-Based Pediatrics,2011,6(5):321-323.DOI:10.3969/j.issn.1673-5501.2011.05.001.
2 冯杰雄.美国新生儿坏死性小肠结肠炎研究现状[J].中华小儿外科杂志,2006,27(7):386-387.DOI:10.3760/cma.j.issn.0253-3006.2006.07.015.Feng JX.Research status of neonatal necrotizing enterocolitis in the United States[J].Chinese Journal of Pediatric Surgery,2006,27(7):386-387.DOI:10.3760/cma.j.issn.0253-3006.2006.07.015.
3 陈超.新生儿坏死性小肠结肠炎的临床问题及防治策略[J].中华儿科杂志,2013,51(5):321-325.DOI:10.3760/cma.j.issn.0578-1310.2013.05.001.Chen C.Clinical problems and prevention strategies of neonatal necrotizing enterocolitis[J].Chinese Journal of Pediatrics,2013,51(5):321-325.DOI:10.3760/cma.j.issn.0578-1310.2013.05.001.
4 唐维兵,刘翔,耿其明,等.新生儿坏死性小肠结肠炎的手术指征探讨[J].中华小儿外科杂志,2015,36(2):100-104.DOI:10.3760/cma.j.issn.0253-3006.2015.02.006.Tang WB,Liu X,Geng QM,et al.Indications of surgical treatment for necrotizing enterocolitis[J].Chinese Journal of Pediatric Surgery,2015,36(2):100-104.DOI:10.3760/cma.j.issn.0253-3006.2015.02.006.
5 Markel TA,Crisostomo PR,Wairiuko GM,et al.Cytokines in necrotizing enterocolitis[J].Shock,2006,25(4):329-337.DOI:10.1097/01.shk.0000192126.33823.87.
6 侯龙龙,李仲荣,黄璜,等.新生儿坏死性小肠结肠炎预后相关因素分析[J].临床小儿外科杂志,2014,13(5):396-400.DOI:10.3969/j.issn.1671-6353.2014.05.008.Hou LL,Li ZR,Huang H,et al.Prognostic factors of neonatal necrotizing enterocolitis[J].J Clin Ped Sur,2014,13(5):396-400.DOI:10.3969/j.issn.1671-6353.2014.05.008.
7 Neu J,Walker WA.Necrotizing enterocolitis[J].N Engl J Med,2011,364(3):255-264.DOI:10.1056/NEJMra1005408.
8 Moons KG,Royston P,Vergouwe Y,et al.Prognosis and prognostic research:what,why,and how?[J].BMJ,2009,338(7706):1317-1320.DOI:10.1136/bmj.b375.
9 Borthakur A,Bhattacharyya S,Alrefai WA,et al.Platelet-activating factor-induced NF-kappa B activation and IL-8 production in intestinal epithelial cells are Bcl10-dependent[J].Inflamm Bowel Dis,2010,16(4):593-603.DOI:10.1002/ibd.21092.
10 Maynard AA,Dvorak K,Khallova L,et al.Epidermal growth factor reduces autophagy in intestinal epithelium and in the rat model of necrotizing enterocolitis[J].Am J Physiol Gastrointest Liver Physiol,2010,299(3):614-622.DOI:10.1152/ajpgi.00076.2010.
11 晏俪鸶,余加林.新生儿坏死性小肠结肠炎发病原因及预后研究进展[J].国际儿科学杂志,2016,43(6):470-473.DOI:10.3760/cma.j.issn.1673-4408.2016.06.012.Yan LS,Yu JL.Research advances in the pathogenesis and prognosis of neonatal necrotizing enterocolitis[J].International Journal of Pediatrics,2016,43(6):470-473.DOI:10.3760/cma.j.issn.1673-4408.2016.06.012.
12 Kliegman RM,Hack M,Jones P,et al.Epidemiologic study of necrotizing enterocolitis among low-birth-weight infants.Absence of identifiable risk factors[J].Journal of Pediatrics,1982,100(3):440-444.
13 刘淼清,王永飚,李仲荣,等.45例新生儿坏死性小肠结肠炎的诊疗体会[J].临床小儿外科杂志,2010,9(1):76-77.DOI:10.3969/j.issn.1671-6353.2010.01.034.Liu MQ,Wang YB,Li ZR,et al.Diagnosis and treatment of neonatal necrotizing enterocolitis:a report of 45 cases[J].J Clin Ped Sur,2010,9(1):76-77.DOI:10.3969/j.issn.1671-6353.2010.01.034.
14 Gephart SM,McGrath JM,Effken JA,et al.Necrotizing enterocolitis risk:state of the science[J].Adv Neonatal Care,2012,12(2):77-87.DOI:10.1097/ANC.0b013e31824cee94.
15 Gagliardi L,Bellu R,Cardilli V,et al.Necrotising enterocolitis in very low birth weight infants in Italy:incidence and non-nutritional risk factors[J].J Pediatr Gastroenterol Nutr.2008,47(2):206-210.DOI:10.1097/MPG.0b013e318174e855.
16 Kamoji VM,Dorling JS,Manktelow B,et al.Antenatal umbilical Doppler abnormalities:an independent risk factor for early onset neonatal necrotizing enterocolitis in premature infants[J].Acta Paediatr,2008,97(3):327-331.DOI:10.1111/j.1651-2227.2008.00671.x.
17 Gregory KE.Clinical predictors of necrotizing enterocolitis in premature infants[J].Nurs Res,2008,57(4):260-270.DOI:10.1097/01.NNR.0000313488.72035.a9.
Memo
收稿日期:2018-01-14。
通讯作者:陈焕,Email:1933258744@qq.com