Colarelli Andrea Marian, Barbian Maria Estefania, Denning Patricia Wei
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, Georgia.
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta Emory University Division of Neonatology and Children's Healthcare of Atlanta, Atlanta, GA, Georgia.
Curr Treat Options Pediatr. 2024 Sep;10(3):126-146. doi: 10.1007/s40746-024-00297-2. Epub 2024 Jun 3.
Necrotizing enterocolitis (NEC) is a serious intestinal disease which primarily affects preterm infants. The pathogenesis of NEC is multifactorial. Thus, it is complicated to study, prevent, and manage.
The purpose of this review is to provide a comprehensive summary of recent research and provide recommendations for the prevention and management of NEC. Currently, management is supportive and non-specific and long-term outcomes for surgical NEC are poor.
The most important strategy to prevent NEC is to provide preterm infants with a human milk diet, minimize exposure to antibiotics and avoid medications that disturb the intestinal microbiome.
Strategies to optimize the infant's intestinal microbiome are critical, as disturbances in the intestinal microbiome composition are a major factor in the pathogenesis of this disease. Optimizing maternal health is also vital to prevent prematurity and neonatal morbidity. Ongoing research holds promise for the implementation of new diagnostic modalities, preventive strategies, and medical treatment options to improve outcomes for premature infants.
坏死性小肠结肠炎(NEC)是一种主要影响早产儿的严重肠道疾病。NEC的发病机制是多因素的。因此,对其进行研究、预防和管理都很复杂。
本综述的目的是全面总结近期研究,并为NEC的预防和管理提供建议。目前,治疗以支持性和非特异性为主,手术治疗NEC的长期预后较差。
预防NEC的最重要策略是为早产儿提供母乳饮食,尽量减少抗生素暴露,并避免使用干扰肠道微生物群的药物。
优化婴儿肠道微生物群的策略至关重要,因为肠道微生物群组成的紊乱是该疾病发病机制的主要因素。优化孕产妇健康对于预防早产和新生儿发病也至关重要。正在进行的研究有望实现新的诊断方法、预防策略和医疗选择,以改善早产儿的预后。