Faculty of Science, University of Alberta, Edmonton, Alberta, Canada; Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Semin Fetal Neonatal Med. 2019 Apr;24(2):133-141. doi: 10.1016/j.siny.2019.01.009. Epub 2019 Feb 5.
Neonatal abstinence syndrome is defined by signs and symptoms of withdrawal that infants develop after intrauterine maternal drug exposure. All infants with documented in utero opioid exposure, or a high pre-test probability of exposure should have monitoring with a standard assessment instrument such as a Finnegan Score. A Finnegan score of >8 is suggestive of opioid exposure, even in the absence of declared use during pregnancy. At least half of infants in most locales can be treated without the use of pharmacologic means. For this reason, symptom scores will drive the decision for pharmacologic therapy. Nevertheless, all infants, regardless of initial manifestations, should be first be managed with non-pharmacologic approaches which in turn, should not be considered as the sole alternative to drug therapy, but rather, as the base upon which all patients are treated. Those who continue to have symptoms despite supportive care should be pharmacologically treated, which in the most severe cases, is life-saving.
新生儿戒断综合征是指胎儿在子宫内暴露于母体药物后出现的戒断症状和体征。所有有记录的宫内阿片类药物暴露或高产前暴露可能性的婴儿都应该使用标准评估工具（如芬尼根评分）进行监测。芬尼根评分>8 提示阿片类药物暴露，即使在怀孕期间没有声明使用。在大多数情况下，至少有一半的婴儿可以不经药物治疗而得到治疗。因此，症状评分将决定是否需要药物治疗。然而，无论最初的表现如何，所有婴儿都应该首先接受非药物治疗方法，而这种方法不应被视为药物治疗的唯一替代方法，而应被视为所有患者治疗的基础。那些尽管接受了支持性治疗仍有症状的婴儿应该接受药物治疗，在最严重的情况下，这是救命的。
