Noerr Barbara
Neonatal Intensive Care Unit, Penn State Milton S. Hershey Medical Center, Mail Code H108, 500 University Dr, PO Box 850, Hershey, PA 17033, USA.
Adv Neonatal Care. 2003 Jun;3(3):107-20. doi: 10.1016/s1536-0903(03)00072-9.
Necrotizing enterocolitis (NEC) has widespread implications for neonates. While mostly affecting preterm neonates, full-term neonates, especially those with congenital heart disease, are also at risk. Although the exact pathogenesis of NEC remains elusive, three major factors, a pathogenic organism, enteral feedings, and bowel compromise, coalesce in at-risk neonates to produce bowel injury. Initiation of the inflammatory cascade likely serves as a common pathway for the disorder. Clinical signs and symptoms range from mild feeding intolerance with abdominal distension to catastrophic disease with bowel perforation, peritonitis, and cardiovascular collapse. Vigilant assessment of at-risk neonates is crucial. When conservative medical management fails to halt injury, surgical intervention is often needed. Strategies to decrease the incidence and ultimately prevent NEC loom on the horizon, such as exclusive use of human breastmilk for enteral feedings and administration of probiotics.
坏死性小肠结肠炎（NEC）对新生儿有广泛影响。虽然主要影响早产儿，但足月儿，尤其是患有先天性心脏病的足月儿也有风险。尽管NEC的确切发病机制仍不清楚，但三个主要因素，即致病微生物、肠内喂养和肠道受损，在高危新生儿中共同作用导致肠道损伤。炎症级联反应的启动可能是该疾病的共同途径。临床体征和症状从伴有腹胀的轻度喂养不耐受到伴有肠穿孔、腹膜炎和心血管衰竭的灾难性疾病不等。对高危新生儿进行警惕的评估至关重要。当保守的药物治疗无法阻止损伤时，通常需要手术干预。降低NEC发病率并最终预防NEC的策略即将出现，例如仅使用人乳进行肠内喂养和给予益生菌。
