【从儿科角度探讨新生儿坏死性小肠结肠炎的防治】。

F Pohlandt
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引用次数: 5

摘要

1. 肠内喂养和促进肠道缺氧和缺血的因素被认为是导致新生儿坏死性小肠结肠炎的原因,但尚未被证明是NEC发病的因素。原则上可在出生第一天开始肠内喂养,剂量为10- 20ml /kg/天。与此相反的对照结果尚未发表。2. 渗透压高的药物应尽量用牛奶稀释,以免损伤粘膜。3.在流行性NEC病例中,证实患病的婴儿应被隔离。使用杀菌和杀病毒的消毒剂对手部消毒是必要的。4. 早期诊断和早期治疗对于防止病情发展到晚期是必要的。5. 抗生素治疗应选择覆盖整个病房的细菌谱。6. 应经常进行身体、放射学和超声检查,以监测疾病的进程。实验室分析应包括:酸碱状态、白细胞、鉴别血象、血小板、c反应蛋白、红细胞压积、血清电解质。7. 大量的液体可能是必要的,以防止和治疗低血容量性休克。8. 腹部穿刺术有助于识别腹膜炎和肠坏疽,并尽早进行手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Prevention and treatment of necrotizing enterocolitis in the newborn infant from the pediatric point of view].

1. Enteral feeding and factors promoting hypoxia and ischaemia of the gut are thought to cause necrotising enterocolitis of the newborn but have not been proven as factors in the pathogenesis of NEC. Enteral feeding may be started in principle on the first day of life at a rate of 10-20 ml/kg/day. Controlled results to the contrary have not been published. 2. Drugs which have a high osmolarity should be diluted with milk as far as possible to avoid mucosal damage. 3. In cases of epidemic NEC, infants with proven disease should be isolated. The use of a bactericidal and virucidal disinfectant is imperative for hand disinfection. 4. Early diagnosis and early treatment are necessary to prevent progression to advanced stages. 5. Antibiotic treatment should be selected to cover the entire bacterial spectrum of the ward. 6. Frequent physical, radiological and ultrasound examinations should be done to monitor the course of the disease. Laboratory analyses should include: acid-basis status, leukocytes, differential blood picture, thrombocytes, C-reactive protein, haematocrit, serum electrolytes. 7. Large amounts of fluid may be necessary to prevent and treat hypovolaemic shock. 8. Abdominal paracentesis helps to recognise peritonitis and intestinal gangrene and allows surgical treatment as early as possible.

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