Roulet M, Prod'hom L S
Helv Paediatr Acta. 1979;34(5):405-15.
Nineteen newborn infants with necrotizing enterocolitis, proved by autopsy or surgical examination, are presented. In this study the absence of blood in the stools and of pneumatosis intestinalis did not exclude the diagnosis of necrotizing enterocolitis. The role of umbilical arterial and venous catheters and of exchange transfusion in the pathogenesis of the disease was less than has been previously reported. There was no evidence for emboli of thrombosis in the mesenteric vessels. On the other hand, the probable importance of nonocclusive mesenteric arterial insufficiency is supported by several observations, including the high incidence of antecedent hypoxaemic episodes, the time of onset of the subsequent gastrointestinal pathology and the localization of the lesions. An infectious component was demonstrated, but our results do not allow to state precisely the time of its occurrence.
本文报告了19例经尸检或手术检查证实患有坏死性小肠结肠炎的新生儿。在本研究中,大便中无血及无肠壁积气并不能排除坏死性小肠结肠炎的诊断。脐动静脉导管及换血疗法在该疾病发病机制中的作用比先前报道的要小。没有证据表明肠系膜血管中有血栓栓塞。另一方面,包括先前低氧血症发作的高发生率、随后胃肠道病变的发病时间以及病变的定位等多项观察结果支持非闭塞性肠系膜动脉供血不足可能具有重要意义。已证实存在感染因素,但我们的结果无法精确说明其发生时间。