先天性巨结肠肠炎与坏死性小肠结肠炎的病理比较  

A pathological comparison between Hirschsprung's enterocolitis and neonate necrotizing enterocolitis

作　　者：张忠德[1] 余亚雄[1] 王怡平[1] 廖贤平[1] 

机构地区：[1]上海第二医科大学附属新华医院病理科

出　　处：《中华病理学杂志》1995年第5期285-287,共3页Chinese Journal of Pathology

摘　　要：对９例新生儿先天性巨结肠（ＨＤ）肠炎和１６例新生儿坏死性小肠结肠炎（ＮＥＣ）的病理分析，发现ＮＥＣ累及的范围较ＨＤ肠炎广泛，ＮＥＣ肠段的出血、炎症也较ＨＤ肠炎严重。结合２１例动物实验的结果，初步探讨了ＨＤ肠炎和ＮＥＣ发病机理。远端梗阻，近端扩张，肠内压力升高，局部血供减少，滞留粪便中的细菌繁殖、侵入肠壁是ＨＤ肠炎的主要原因；而新生儿有窒息、休克缺氧时，小肠、结肠的血液供应减少，加上免疫变态反应的参与，肠道粘膜缺乏ＩｇＡ的保护，肠道致病菌的过度繁殖、侵入肠壁是ＮＥＣ的发病原因。utopsy 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. Frorn our 21 animal experiments in which we tried to clarify the pathogenesis of Hirschsprung's enterocolitis and NEC,our preliminary hypothesis for the development of Hirschsprung's enterocolitis bein: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 in-testinal wall results in NEC.

关 键 词：巨结肠 先天性 结肠炎 病理学 新生儿 小肠炎 

分 类 号：R574.620.2[医药卫生—消化系统] R574.502[医药卫生—内科学]