Ergenekon Ebru, Tayman Cüneyt, Özkan Hilal
Department of Neonatology, Gazi University, Ankara, Turkey.
Department of Neonatology, Health Sciences University, SUAM, Ankara City Hospital, Ankara, Turkey.
Turk Arch Pediatr. 2021 Sep;56(5):513-524. doi: 10.5152/TurkArchPediatr.2021.21164.
Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in the newborn infant, and the incidence varies between 3% and 15% in neonatal intensive care units (NICU). It has a high risk of mortality and both short- and long-term morbidity which severely impacts the quality of life in the survivors. Lack of specific clinical and laboratory findings makes early diagnosis difficult for the clinician and sometimes results in overtreatment for feeding intolerance which is quite frequent in preterms and can easily be confused with NEC. The fact that there are many definitions and presentations of NEC even complicates the management. This review aims to summarize the guideline of the Turkish Neonatal Society for diagnosis, treatment, and prevention of NEC for the clinician taking care of preterms. Etiopathogenesis and various clinical pictures of NEC, as well as diagnostic methods, are defined. Treatment and prognosis are discussed in detail with reference to current literature and preventive strategies are summarized based on evidence. Finally, the approach to baby presenting with suspected NEC is summarized in an algorithm.
坏死性小肠结肠炎（NEC）是新生儿最常见的胃肠道急症之一，在新生儿重症监护病房（NICU）中的发病率在3%至15%之间。它具有较高的死亡率以及短期和长期发病率，严重影响幸存者的生活质量。缺乏特异性的临床和实验室检查结果使得临床医生难以早期诊断，有时会导致对喂养不耐受的过度治疗，而喂养不耐受在早产儿中很常见，且容易与NEC混淆。NEC存在多种定义和表现这一事实甚至使管理变得更加复杂。本综述旨在为照顾早产儿的临床医生总结土耳其新生儿学会关于NEC诊断、治疗和预防的指南。定义了NEC的病因发病机制、各种临床表现以及诊断方法。参考当前文献详细讨论了治疗和预后，并基于证据总结了预防策略。最后，以流程图的形式总结了对疑似NEC婴儿的处理方法。
