Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Clinical Nutrition Department, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.
Nutr Clin Pract. 2018 Aug;33(4):476-482. doi: 10.1002/ncp.10115. Epub 2018 Jun 25.
Necrotizing enterocolitis (NEC) is one of the most significant causes of morbidity and mortality among premature infants. The exact cause is considered multifactorial and related to gastrointestinal immaturity, inflammation and enteral feeding. The role of nutrition is vitally important in NEC. The main modifiable risk factor is the introduction and advancement of enteral feedings. After an infant has recovered from NEC, enteral feeds should be cautiously resumed to prevent injury from prolonged use of parenteral nutrition. The logistics of how, when, and what to feed are somewhat unclear and often depend on the severity of the disease. For patients with an enterostomy, refeeding the distal intestine with the small-intestinal ostomy output may improve bowel growth and prevent long-term complications.
坏死性小肠结肠炎(NEC)是早产儿发病和死亡的主要原因之一。确切病因被认为是多因素的,与胃肠道不成熟、炎症和肠内喂养有关。营养在 NEC 中的作用至关重要。主要可改变的危险因素是肠内喂养的引入和进展。婴儿从 NEC 中康复后,应谨慎恢复肠内喂养,以防止长期使用肠外营养造成损伤。如何、何时以及喂养什么的后勤问题尚不清楚,通常取决于疾病的严重程度。对于有肠造口的患者,用小肠造口输出物再喂养远端肠道可能会促进肠生长并预防长期并发症。