新生儿坏死性小肠结肠炎相对手术适应证和手术时机研究进展  

Research progress on relative surgical indications and surgical timing for necrotizing enterocolitis of newborn

作　　者：刘鑫[1,2] 张莉 Liu Xin;Zhang Li(Graduate Work Department,Xi′an Medical University,Xi′an 710000,China;Department of Neonatology,Northwest Women′s and Children′s Hospital,Xi′an 710061,China)

机构地区：[1]西安医学院研究生工作部,西安710000 [2]西北妇女儿童医院新生儿科,西安710061

出　　处：《中华实用儿科临床杂志》2024年第12期956-960,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：陕西省科技厅重点研发计划项目(2024SF-YBXM-316);西安市科技局医学研究项目(22YXYJ0101)。

摘　　要：坏死性小肠结肠炎(NEC)是一种严重威胁新生儿生命的疾病,其发病机制与胎龄、出生体重、缺氧、感染等多种因素相关。对于需要手术治疗的NEC患儿,手术时机的选择对结局有重要影响。肠穿孔作为NEC绝对手术指征,已得到大多数学者的共识。然而,对于相对手术适应证的选择仍存在争议,这也成为目前NEC研究的热点之一。大部分临床医师主要是经验性判断手术时机,非量化的评估常导致手术时机过早或过晚,不利于改善患儿的结局。本文对NEC相对手术适应证和手术时机评估进行综述,包括手术时机预测评分、影像学X线检查、腹部超声检查、红外光谱检查、实验室检查及NEC手术预测模型,以期为改善临床决策提供依据。Necrotizing enterocolitis(NEC)is a disease that seriously threatens the life of newborns.Its pathogenesis is related to various factors such as gestational age,birth weight,hypoxia,infection,etc.For patients who require surgical treatment,the timing of surgery has an important impact on outcomes.Intestinal perforation has become the consensus of most scholars as an absolute surgical indication for NEC.The relative indications for surgery are still controversial,and therefore,it has become a current NEC research hotspot.Most clinicians judge the timing of surgery based on experience.Non-quantitative evaluation often leads to premature or late timing of surgery,which is not conducive to improving patient outcomes.This article reviews the relative surgical indications and surgical timing assessment for NEC,including surgical timing prediction scores,imaging X-ray examinations,abdominal ultrasonography,infrared spectroscopy,laboratory tests,and NEC surgery prediction models,in order to provide a basis for improving clinical decision-making.

关 键 词：坏死性小肠结肠炎 相对手术适应证 手术时机 婴儿 新生 

分 类 号：R726.5[医药卫生—儿科]