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预防极低出生体重早产儿坏死性小肠结肠炎:可行吗?

Prevention of necrotizing enterocolitis in preterm very low birth weight infants: is it feasible?

作者信息

Lin Hsiang-Yu, Chang Jui Hsing, Chung Mei-Yung, Lin Hung-Chih

机构信息

Department of Pediatrics, Children Hospital, China Medical University, Taichung, Taiwan.

Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Pediatrics, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2014 Aug;113(8):490-7. doi: 10.1016/j.jfma.2013.03.010. Epub 2013 May 20.

Abstract

Necrotizing enterocolitis (NEC) is still one of the most catastrophic intestinal emergencies in preterm very low-birth weight infants. Primary prevention of NEC should be the priority, since NEC frequently progresses from nonspecific signs, to extensive necrosis within a matter of hours with medical or surgical treatment, making successful treatment and secondary prevention difficult to achieve. Currently available strategies for primary prevention of NEC include antenatal glucocorticosteroids, breast milk feeding, cautious feeding strategy, fluid restriction and probiotics. Nonetheless, based on current research evidence, mixed flora probiotics, and/or breast milk feeding, would appear to be the most effective feasible methods in the prevention of NEC at present.

摘要

坏死性小肠结肠炎(NEC)仍然是早产极低出生体重儿最严重的肠道急症之一。NEC的一级预防应是首要任务,因为NEC常常从非特异性症状迅速发展,在数小时内就会发展为广泛坏死,无论采取内科还是外科治疗,都难以成功治疗并进行二级预防。目前可用的NEC一级预防策略包括产前糖皮质激素、母乳喂养、谨慎喂养策略、液体限制和益生菌。尽管如此,基于目前的研究证据,混合菌群益生菌和/或母乳喂养似乎是目前预防NEC最有效可行的方法。

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