坏死性小肠结肠炎(Necrotizing Enterocolitis, NEC)主要发生于低出生体重早产儿,是影响早产儿存活的外科急症之一,其临床症状及体征进展迅速,发病率和死亡率较高。随着围产医学、重症医学的发展,低出生体重早产儿的存活率大大提高,NEC的发病率也随之提高。NEC的初步治疗方案为内科保守治疗,包括胃肠道休息、胃肠减压、应用广谱抗生素、液体复苏、肠外营养支持、对症处理并发症等,若保守治疗未能控制,则需及时外科干预,理想的外科手术时机及手术方式目前尚无定论。文章将讨论如何选择合适的手术干预时机及手术方式,旨在提高NEC患者的总体生存率。Necrotizing enterocolitis (NEC) primarily occurs in low birth weight preterm infants and is one of the surgical emergencies affecting the survival of preterm infants. Its clinical symptoms and signs progress rapidly, with high morbidity and mortality rates. With the development of perinatal medicine and intensive care medicine, the survival rate of low birth weight preterm infants has significantly increased, and the incidence of NEC has also risen. The initial treatment plan for NEC is conservative medical treatment, which includes gastrointestinal rest, gastrointestinal decompression, application of broad-spectrum antibiotics, fluid resuscitation, parenteral nutrition support, and symptomatic management of complications. If conservative treatment fails to control the condition, surgical intervention is necessary. However, the ideal timing and method for surgical intervention are still inconclusive. This review will discuss how to choose the appropriate timing for surgical intervention and the appropriate surgical methods, aiming to improve the overall survival rate of NEC patients.
