新生儿坏死性小肠结肠炎预后研究新进展

Advances in Prognosis Research of Neonatal Necrotizing Enterocolitis

摘要: 新生儿坏死性小肠结肠炎(Necrotizing Enterocolitis, NEC)是一种严重的胃肠道疾病，主要影响早产儿，其高发病率和死亡率使其成为新生儿重症监护的重大挑战。尽管近年来诊治手段不断进步，但NEC患儿的短期和长期预后仍存许多不良结局。本综述旨在总结NEC预后研究的新进展，重点关注并发症、死亡率，以及长期体格和神经发育结局，以期为临床管理NEC患儿和未来研究提供参考。短期预后方面，NEC常导致如肺部感染、败血症、短肠综合征、肠穿孔和肠坏死等并发症，其死亡率受胎龄、出生体重和治疗策略的影响。长期预后方面，NEC存活患儿的体格生长可能受肠道功能障碍和营养支持方案的影响，神经系统发育受多种因素制约，包括出生体重、营养缺失和全身炎症反应等。本研究通过综述NEC预后的临床研究进展，讨论NEC患儿面临的不良预后风险，从而帮助优化随访和干预措施，对提高患儿生存质量至关重要。未来需要进一步探索NEC发病机制与预后之间的关系，以推动更精准的治疗和预防策略。

Abstract: Neonatal necrotizing enterocolitis (NEC) is a severe gastrointestinal disorder predominantly affecting preterm infants, whose high morbidity and mortality rates pose significant challenges in neonatal intensive care. Despite advancements in diagnostic and therapeutic approaches in recent years, the short- and long-term prognoses of infants with NEC remain fraught with adverse outcomes. This review aims to summarize recent progress in NEC prognosis research, focusing on complications, mortality, and long-term physical and neurodevelopmental outcomes, with the goal of informing clinical management and future research. In terms of short-term prognosis, NEC often leads to complications such as pulmonary infections, sepsis, short bowel syndrome, intestinal perforation, and intestinal necrosis, with mortality influenced by gestational age, birth weight, and treatment strategies. Regarding long-term prognosis, the physical growth of NEC survivors may be affected by intestinal dysfunction and nutritional support regimens, while neurodevelopmental outcomes are influenced by multiple factors, including birth weight, nutritional deficiencies, and systemic inflammatory responses. By reviewing clinical research advancements in NEC prognosis, this study discusses the risks of adverse outcomes faced by NEC patients, thereby aiding in the optimization of follow-up and intervention strategies, which are crucial for improving the quality of life of these infants. Future research should further explore the relationship between the pathogenesis of NEC and its prognosis to promote more precise treatment and prevention strategies.