PDF(Pubmed)
Abstract：
Surgically treated necrotising enterocolitis (sNEC) is associated with significantly worse neurodevelopmental outcomes than that seen in premature infants without NEC. We aim to review the association between factors involved in the surgical treatment of NEC and subsequent neurodevelopmental outcomes to identify potential areas for improvement. The PubMed and Embase databases were interrogated for articles reporting neurodevelopmental outcomes in babies treated surgically for NEC using key terms including: \"Infant\", \"Necrotising enterocolitis\", \"Surgical\", \"Neurodevelopmental\" and \"Outcomes\". The search strategy yielded 1170 articles and after applying inclusion and exclusion criteria 22 studies remained and formed the review. A diverse range of neurodevelopmental outcomes were reported. Extreme prematurity and lower birth weight were associated with worse neurodevelopmental outcomes. The use of peritoneal drains and enterostomies were associated with worse outcomes. Modifications to surgical strategies in NEC may improve neurodevelopmental outcomes but the effect of confounding factors remains unclear. Further large scale studies are required to define the optimum strategies for treating NEC surgically and to develop a core outcome set for research into NEC.
摘要：
手术治疗的坏死性小肠结肠炎（sNEC）与没有NEC的早产儿相比，神经发育结局明显更差。我们旨在回顾NEC手术治疗中涉及的因素与随后的神经发育结果之间的关联，以确定潜在的改善领域。在PubMed和Embase数据库中询问了报告NEC手术治疗婴儿神经发育结果的文章，其中使用的关键术语包括：“婴儿”，“坏死性小肠结肠炎”，\“外科\”，“神经发育”和“结果”。搜索策略产生了1170篇文章，在应用纳入和排除标准后，保留了22项研究并形成了综述。报告了不同范围的神经发育结果。极端早产和较低的出生体重与较差的神经发育结果相关。腹膜引流和肠造口术的使用与较差的预后相关。NEC手术策略的修改可能会改善神经发育结果，但混杂因素的影响尚不清楚。需要进一步的大规模研究来定义手术治疗NEC的最佳策略，并为NEC研究开发核心结果集。
