Zhang Z, She Y, Wang Y
Department of Pathology, Xinhua Hospital, Shanghai Second Medical University.
Zhonghua Bing Li Xue Za Zhi. 1995 Oct;24(5):285-7.
Autopsy records of 9 cases of neonate Hirschsprung's enterocolitis (HD) and 16 cases of neonate necrotizing enterocolitis (NEC) were analysed. It was found that the NEC lesions were more extensive than HD lesions, the bleeding and inflammation in NEC were also more serious than in HD. From our 21 animal experiments in which we tried to clarify the pathogenesis of Hirschsprung's enterocolitis and NEC, our preliminary hypothesis fro the development of Hirschsprung's enterocolitis being: the distal segment was first obstructed, causing the proximal segment to expand, the increase of pressure within the bowel resulted in ischemia of the intestines, increased bacterial multiplication in the retained feces and bacterial infiltration of the intestinal mucosa. The above being the major cause of HD. When the neonate is in asphyxia or shock, ischemia of the intestines and immunoallergic reactions occur, due to the lack of IgA in the mucosa, the multiplication and infiltration of pathogenic enterobacteria in the intestinal wall results in NEC.
对9例新生儿先天性巨结肠肠炎（HD）和16例新生儿坏死性小肠结肠炎（NEC）的尸检记录进行了分析。发现NEC病变比HD病变更广泛，NEC中的出血和炎症也比HD更严重。在我们试图阐明先天性巨结肠肠炎和NEC发病机制的21项动物实验中，我们对先天性巨结肠肠炎发展的初步假说是：远端节段首先受阻，导致近端节段扩张，肠内压力增加导致肠道缺血，留存粪便中细菌繁殖增加以及肠道黏膜细菌浸润。上述情况是HD的主要病因。当新生儿出现窒息或休克时，会发生肠道缺血和免疫过敏反应，由于黏膜中缺乏IgA，致病性肠道细菌在肠壁内繁殖和浸润导致NEC。
