King Nancy
The Children's Hospital, 1056 E. 19th Avenue, Denver, CO 80218, USA.
J Pediatr Oncol Nurs. 2002 Nov-Dec;19(6):198-204. doi: 10.1177/104345420201900604.
Neutropenic enterocolitis (NE) is a serious complication in neutropenic patients. Once exclusively thought to be found in patients with leukemia and lymphoma, it is now being seen with increased frequency during bone marrow transplant, chemotherapy for solid tumors, and in patients suffering from acquired immune deficiency syndrome and cyclic neutropenia. The pathophysiology of NE is not completely understood, but unquestionably involves neutropenia, mucosal barrier damage, and infection resulting in a necrotizing process of the bowel wall. The cecum, ileus, and ascending colon are most commonly involved. Initial symptoms are usually nonspecific abdominal pain and fever. Localized, severe right lower quadrant pain, sepsis, and bowel perforation may rapidly develop. Once considered a fatal complication, the outcome for the child with NE has improved with better diagnostic imaging techniques and antibiotics. Most children can be successfully managed conservatively with early introduction of broad-spectrum antibiotics and supportive care. However, a significant number will need surgical intervention. Nursing care of these children requires knowledge of the disease process, excellent clinical assessment skills, and a compassionate, family-centered approach.
中性粒细胞减少性小肠结肠炎（NE）是中性粒细胞减少患者的一种严重并发症。它曾一度被认为仅见于白血病和淋巴瘤患者，而现在在骨髓移植、实体瘤化疗期间以及获得性免疫缺陷综合征和周期性中性粒细胞减少症患者中越来越频繁地出现。NE的病理生理学尚未完全明确，但无疑涉及中性粒细胞减少、黏膜屏障损伤以及感染导致肠壁坏死过程。盲肠、回肠和升结肠最常受累。初始症状通常是非特异性腹痛和发热。可能迅速出现局部严重右下腹疼痛、脓毒症和肠穿孔。NE曾被认为是一种致命并发症，随着诊断成像技术和抗生素的改进，患NE儿童的预后有所改善。大多数儿童通过早期使用广谱抗生素和支持性护理可成功进行保守治疗。然而，相当一部分患儿需要手术干预。对这些儿童的护理需要了解疾病过程、具备出色的临床评估技能以及采取富有同情心的、以家庭为中心的方法。
