Neonatal Intensive Care Unit, Department of Women's and Children's Health, University Hospital of Padova, 35128 Padova, Italy.
Pediatric Surgery Unit, Department of Women's and Children's Health, University Hospital of Padova, 35128 Padova, Italy.
Nutrients. 2021 Jan 24;13(2):340. doi: 10.3390/nu13020340.
Necrotizing enterocolitis (NEC), the first cause of short bowel syndrome (SBS) in the neonate, is a serious neonatal gastrointestinal disease with an incidence of up to 11% in preterm newborns less than 1500 g of birth weight. The rate of severe NEC requiring surgery remains high, and it is estimated between 20-50%. Newborns who develop SBS need prolonged parenteral nutrition (PN), experience nutrient deficiency, failure to thrive and are at risk of neurodevelopmental impairment. Prevention of NEC is therefore mandatory to avoid SBS and its associated morbidities. In this regard, nutritional practices seem to play a key role in early life. Individualized medical and surgical therapies, as well as intestinal rehabilitation programs, are fundamental in the achievement of enteral autonomy in infants with acquired SBS. In this descriptive review, we describe the most recent evidence on nutritional practices to prevent NEC, the available tools to early detect it, the surgical management to limit bowel resection and the best nutrition to sustain growth and intestinal function.
新生儿坏死性小肠结肠炎（NEC）是导致短肠综合征（SBS）的首要原因，是一种严重的新生儿胃肠道疾病，出生体重＜1500g 的早产儿发病率高达 11%。需要手术治疗的严重 NEC 发生率仍然很高，估计在 20-50%之间。患有 SBS 的新生儿需要长期肠外营养（PN），会出现营养缺乏、生长不良的情况，并且存在神经发育损伤的风险。因此，预防 NEC 是避免 SBS 及其相关并发症的必要措施。在这方面，营养实践似乎在生命早期发挥着关键作用。个体化的医疗和手术治疗以及肠道康复计划对于获得性 SBS 婴儿实现肠内自主至关重要。在本描述性综述中，我们描述了预防 NEC 的最新营养实践证据、早期发现 NEC 的可用工具、限制肠切除的手术管理以及维持生长和肠道功能的最佳营养。
