Sato Thomas T, Oldham Keith T
Division of Pediatric Surgery, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI 53201, USA.
Clin Perinatol. 2004 Sep;31(3):577-89. doi: 10.1016/j.clp.2004.03.017.
Perforated NEC in the fragile, premature infant remains a complex neonatal and surgical problem. Future investigation into the basic mechanisms of the intestinal inflammatory response in the premature neonate may allow for preventive strategies in the management of NEC. Until then, surgical management for perforated NEC will remain a necessary intervention to treat the complications of this disease. The two most commonly used surgical strategies for perforated NEC are laparotomy, bowel resection, and enterostomy versus primary peritoneal drainage. There are no compelling, prospective, controlled data supporting one procedure over the other. Although there are several surgical options for treating perforated NEC, definitive evidence-based guidelines for the best surgical treatment in terms of survival outcome remain to be determined.
对于脆弱的早产儿来说，坏死性小肠结肠炎（NEC）穿孔仍然是一个复杂的新生儿及外科问题。未来对早产新生儿肠道炎症反应基本机制的研究可能会为NEC的管理带来预防策略。在此之前，NEC穿孔的外科治疗仍将是治疗该疾病并发症的必要干预措施。NEC穿孔最常用的两种外科策略是剖腹手术、肠切除和肠造口术与单纯腹腔引流术。目前尚无令人信服的前瞻性对照数据支持一种手术方式优于另一种。虽然有几种手术方法可用于治疗NEC穿孔，但关于最佳手术治疗在生存结局方面的确切循证指南仍有待确定。
