输血相关性坏死性小肠结肠炎的思考

雷小平; 罗丽娟

doi:10.12372/jcp.2022.22e0361

临床儿科杂志 >

2022 , Vol. 40 >Issue 9: 647 - 653

DOI: https://doi.org/10.12372/jcp.2022.22e0361

专家笔谈

输血相关性坏死性小肠结肠炎的思考

雷小平 ,
罗丽娟

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西南医科大学附属医院儿科（新生儿）四川省出生缺陷临床医学研究中心（四川泸州 646000）

雷小平,医学博士,硕士研究生导师,主任医师,西南医科大学附属医院儿科副主任。四川省学术和技术带头人后备人选,兼任中华医学会围产医学专业委员会青年委员,中华医学会儿科学专业委员会青年委员,中华医学会儿科学专业委员会新生儿学组青年委员,四川省医学会围产医学会委员,《临床儿科杂志》青年编委。从事新生儿临床、教学、科研工作20年,主要研究方向为围产流行病学。承担国家自然科学基金、四川省自然科学基金等科研项目8项,发表学术论文50余篇,其中SCI收录20余篇。获西南医科大学“金教鞭”及“优秀教师”奖。

收稿日期: 2022-03-17

网络出版日期: 2022-08-26

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Transfusion-associated necrotizing enterocolitis

Xiaoping LEI ,
Lijuan LUO

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Division of Neonatology, Department of Pediatrics, Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Birth Defects, Luzhou 646000, Sichuan, China

Received date: 2022-03-17

Online published: 2022-08-26

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摘要

新生儿坏死性小肠结肠炎（NEC）是一种新生儿时期严重威胁生命的胃肠道疾病,多以腹胀、呕吐、血便及休克等非特异性症状为主要临床表现,在早产儿中症状更不典型。目前广泛被认可的NEC病因包括早产、感染、缺氧缺血和喂养不当等。近年来,红细胞输注（RBCT）与NEC之间的相关性受到广泛关注。文章通过梳理输血与NEC的相关性、输血相关性坏死性小肠结肠炎（TANEC）的影响因素及发病机制和TANEC的预防等方面的研究进展,认为TANEC是客观存在的,但贫血本身才是TANEC的发病基础,预防贫血、合理输血是减少TANEC的基本策略。

关键词： 坏死性小肠结肠炎; 红细胞输注; 新生儿

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雷小平 , 罗丽娟 . 输血相关性坏死性小肠结肠炎的思考[J]. 临床儿科杂志, 2022 , 40(9) : 647 -653 . DOI: 10.12372/jcp.2022.22e0361

Abstract

Neonatal necrotizing enterocolitis (NEC) is a serious and life-threatening gastrointestinal disease in the neonatal period. The atypical clinical manifestations of NEC, especially in premature infants, are abdominal distension, vomiting, bloody stools and shock. At present, the widely known pathogenesis of NEC includes preterm birth, infection, hypoxia-ischemia and improper feeding, etc. In recent years, the association between red blood cell transfusion (RBCT) and NEC was widely concerned. This article reviewed the relationship between RBCT and NEC, the influence factors, possible pathologic mechanism and the prevention strategies of transfusion-associated necrotizing enterocolitis (TANEC). Based on the available evidences, the author believes that TANEC is a clinical condition. However, anemia is the basis for the onset of TANEC. Prevention of anemia and reasonable blood transfusion are the basic strategies to reduce TANEC.

Key words： necrotizing enterocolitis; red blood cell transfusion; newborn

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