Bolisetty S, Lui K, Oei J, Wojtulewicz J
Royal Hospital for Women, University of New South Wales, Sydney, Australia.
Acta Paediatr. 2000 Oct;89(10):1226-30. doi: 10.1080/080352500750027619.
The aetiology of necrotizing enterocolitis (NEC) remains poorly understood in infants of all gestation, particularly when it occurs at term. We hypothesize that NEC in term infants is rare but often associated with underlying congenital illnesses.
Records of all term infants hospitalized with radiologically or surgically proven NEC in the 10 tertiary centres of two geographical regions of Australia during a 6.5-y period were reviewed. Regional birth data were obtained and a special care nursery survey was conducted.
Twenty-nine infants had proven NEC giving a population incidence of 0.05 per 1000 live births. Nineteen (66%) of them had underlying congenital diseases. Five (17%) infants had endocrine disorders, which included panhypopituitarism, hypothyroidism, hypoparathyroidism and congenital adrenal hyperplasia. Ten infants had congenital heart disease, eight being cyanotic. Six of them developed NEC prior to any invasive cardiac procedures. Seven of the other nine infants without any congenital diseases had perinatal risk factors associated with NEC. The severity of illness was not different amongst the three groups. All infants, except two, survived.
NEC in term infants is commonly secondary to or preceded by underlying congenital diseases. A considerable proportion of NEC cases had co-existing endocrine illnesses.
坏死性小肠结肠炎（NEC）的病因在所有孕周的婴儿中仍未完全明确，尤其是足月时发病的情况。我们推测足月婴儿患NEC较为罕见，但常与潜在的先天性疾病有关。
回顾了澳大利亚两个地理区域的10个三级中心在6.5年期间收治的所有经放射学或手术证实为NEC的足月婴儿的记录。获取了区域出生数据并进行了特殊护理病房调查。
29名婴儿被证实患有NEC，人群发病率为每1000例活产0.05例。其中19名（66%）有潜在的先天性疾病。5名（17%）婴儿患有内分泌疾病，包括全垂体功能减退、甲状腺功能减退、甲状旁腺功能减退和先天性肾上腺增生。10名婴儿患有先天性心脏病，8名有青紫症状。其中6名在进行任何侵入性心脏手术前就发生了NEC。其他9名无任何先天性疾病的婴儿中有7名有与NEC相关的围产期危险因素。三组之间疾病严重程度无差异。除两名婴儿外，所有婴儿均存活。
足月婴儿的NEC通常继发于潜在的先天性疾病或在其之前发生。相当一部分NEC病例合并有内分泌疾病。
