Cezard J P, Aigrain Y, Sonsino E, Lambert N, Macry J, Grasset E, Weisgerber G, Navarro J
Service de Gastroentérologie Pédiatrique, Hôpital Robert Debré, Paris, France.
J Pediatr Surg. 1992 Nov;27(11):1427-32. doi: 10.1016/0022-3468(92)90192-a.
Repeated or prolonged organic obstruction of the small intestine in the neonatal period can lead to severe refeeding problems, despite a transient ostomy. These problems are thought to result from a postobstructive enteropathy (POE) of the apparently normal small intestine segment above the obstruction. Ten infants with a POE, characterized by limited oral caloric and carbohydrate intakes and increased ostomy effluent, were compared with 8 controls with an enterostomy and a normal postoperative refeeding pattern. There was no statistical difference in the histomorphometric appearance of the mucosa or its digestive or absorptive capacity (brush-border hydrolases, glucose transport) between the two groups. The effluent and duodenal floras of the two groups were similar. However, all POE patients showed significant abnormal peristalsis characterized by barium and carmin transit times. This suggests that repeated or prolonged obstruction in the neonatal period could lead to a POE, caused by chronic motricity abnormalities of the small intestine above the obstruction. Although this POE is more frequent after small bowel atresia, it may also occur with other conditions causing prenatal and postnatal intestinal obstruction.
新生儿期小肠反复或长期的器质性梗阻，即便进行了临时性造口术，仍可能导致严重的再喂养问题。这些问题被认为是由梗阻上方看似正常的小肠段发生的梗阻后肠病（POE）所致。将10例患有POE（其特征为口服热量和碳水化合物摄入受限以及造口排出物增加）的婴儿与8例有肠造口术且术后再喂养模式正常的对照组婴儿进行了比较。两组之间黏膜的组织形态计量学外观及其消化或吸收能力（刷状缘水解酶、葡萄糖转运）没有统计学差异。两组的排出物和十二指肠菌群相似。然而，所有POE患者均表现出明显的异常蠕动，其特征为钡剂和胭脂红通过时间异常。这表明新生儿期反复或长期的梗阻可能导致POE，其由梗阻上方小肠的慢性动力异常引起。尽管这种POE在小肠闭锁后更为常见，但也可能发生于其他导致产前和产后肠梗阻的情况。
