Kuschel Carl
Auckland District Health Board, Private Bag 92 024, Auckland, New Zealand.
Semin Fetal Neonatal Med. 2007 Apr;12(2):127-33. doi: 10.1016/j.siny.2007.01.004. Epub 2007 Feb 23.
The management of the infant exposed to drugs in utero poses significant challenges. Symptoms and signs of neonatal abstinence syndrome (NAS) are non-specific but most commonly associated with withdrawal from maternal opioids. A high index of suspicion is required when presented with an infant who could be manifesting symptoms of NAS. In the absence of a reliable history of maternal drug exposure, analysis of neonatal meconium or urine may be indicated. Approximately 90% of infants exposed to opioids will exhibit signs of NAS, although a smaller proportion will require pharmacological treatment. Although few studies have evaluated the advantages of different therapeutic agents and strategies, opioid withdrawal is best treated initially with opioid medication. Supportive care of the infant should include assessment of the adequacy of feeding, evaluation of social circumstances (particularly child protection issues) and surveillance for transmission of viral infection.
对子宫内接触药物的婴儿进行管理面临重大挑战。新生儿戒断综合征（NAS）的症状和体征不具特异性，但最常与母亲停用阿片类药物有关。当面对可能表现出NAS症状的婴儿时，需要高度怀疑。在没有可靠的母亲药物接触史的情况下，可能需要对新生儿胎粪或尿液进行分析。约90%接触阿片类药物的婴儿会出现NAS体征，尽管需要药物治疗的比例较小。虽然很少有研究评估不同治疗药物和策略的优势，但阿片类药物戒断最初最好用阿片类药物治疗。对婴儿的支持性护理应包括评估喂养是否充足、评估社会情况（特别是儿童保护问题）以及监测病毒感染的传播。
