99新生儿坏死性小肠结肠炎

NeonatalnecrotizingenterocolitisKunyaoYuOutline•Riskfactor•Bacterial&NEC•Intestinaldefensemechanism•Clinicalpresentation•Bell’sstage•TreatmentRiskFactor•Premature•Lowbirthweight(1500g)•Broad-spectrumantibiotics•FeedingBacterial&NEC•Intestinalbacterialcolonizationintheinfant-Deliverymethod-FeedingDeliveredvaginallyDeliveredviacesareansectionBacterialColonizationLactobacillus,Prevotella,SneathiaStaphylococcus,Corynebacterium,PropionibacteriumBreast-fedFormula-fedBacterialColonizationBifidobacterium,Lactobacillus,StreptococcusBifidobacterium,Staphylococcus,Escherichiacoli,ClostridiaIntestinaldefensemechanism•Peristalsis•Gastricacid•Proteolyticenzymes•Intestinalmucus•Cellsurfaceglycoconjugates•Cell’stightjunctions•ImmunologyClinicalpresentation•Abdominalsign:distension,vomiting,hematochezia•Feedingintolerance•Lethargy•Temperatureinstability•HypotensionImageBell’sstageTreatment•StageIa:-NPO•StageIb-IIb/IIIa:-NPO-Broadspectrumantibotics•StageIIIa-IIIb:-Surgery/PeritonealdrainProbiotics-treat?Probiotics-treat?•Whatistheoptimalprobioticorganism(s)?•Whatistheoptimaladministrationincludingassessmentofwhatpatientsarethebestcandidatesfortreatment?•Whatistheoptimalprobioticdose?•Whatisthebesttimingofadministration?•Whatisthemostefficaciouslengthoftreatment?THANKYOU