患有缺氧缺血性脑病的足月新生儿坏死性小肠结肠炎
Necrotizing Enterocolitis in a Term Newborn With Hypoxic-Ischemic Encephalopathy.
摘要(中文译文)
坏死性小肠结肠炎（NEC）主要影响早产儿，在足月新生儿中仍属少见。当其在足月新生儿中发生时，通常反映存在潜在易感性或累积的围产期危险因素。我们报告一例足月男婴（胎龄40+1周）在多种危险因素背景下发生NEC，包括围产期窒息并缺氧缺血性脑病并接受治疗性低温治疗、疑似早发型新生儿感染需经验性抗生素治疗，以及配方奶喂养。生后第4天，患儿出现急腹症表现。影像学显示气腹，手术证实为NEC伴结肠穿孔。组织病理学显示炎症性和出血性坏死，并排除了先天性巨结肠。行结肠造口术，6个月时恢复肠道连续性，18个月时神经发育正常。本病例提示，足月新生儿NEC虽罕见，但可能由多种围产期损伤共同作用所致，包括缺氧缺血性损伤和治疗性低温，并强调需仔细评估损害肠道完整性的易感因素。
Abstract
Necrotizing enterocolitis (NEC) predominantly affects preterm infants and remains uncommon in term neonates. When it occurs in full-term newborns, it usually reflects underlying vulnerability or cumulative perinatal risk factors. We report the case of a term male newborn (40 + 1 weeks' gestation) who developed NEC in the context of multiple risk factors, including perinatal asphyxia with hypoxic-ischemic encephalopathy managed by therapeutic hypothermia, suspected early-onset neonatal infection requiring empirical antibiotics, and formula feeding. On day 4 of life, the infant presented with signs of an acute abdomen. Imaging revealed pneumoperitoneum, and surgery confirmed NEC with colonic perforation. Histopathology demonstrated inflammatory and hemorrhagic necrosis, and Hirschsprung's disease was excluded. A colostomy was performed, with restoration of intestinal continuity at six months and normal neurodevelopment at 18 months. This case highlights that NEC in term neonates, although rare, may result from the convergence of multiple perinatal insults, including hypoxic-ischemic injury and therapeutic hypothermia, and underscores the need for careful evaluation of predisposing factors that compromise intestinal integrity.
如何引用
AMA
Abdessamad Lalaoui, Ghizlane Kassal, Khalid Abi El Aala, Fatiha Bennaoui, Nadia El Idrissi Slitine, Fadl Mrabih Rabou Maoulainine. Necrotizing Enterocolitis in a Term Newborn With Hypoxic-Ischemic Encephalopathy.. Cureus. 2026; doi:10.7759/cureus.106673.
APA
Abdessamad Lalaoui, Ghizlane Kassal, Khalid Abi El Aala, Fatiha Bennaoui, Nadia El Idrissi Slitine, Fadl Mrabih Rabou Maoulainine (2026). Necrotizing Enterocolitis in a Term Newborn With Hypoxic-Ischemic Encephalopathy.. Cureus. https://doi.org/10.7759/cureus.106673
GB/T 7714
Abdessamad Lalaoui, Ghizlane Kassal, Khalid Abi El Aala, Fatiha Bennaoui, Nadia El Idrissi Slitine, Fadl Mrabih Rabou Maoulainine. Necrotizing Enterocolitis in a Term Newborn With Hypoxic-Ischemic Encephalopathy.[J]. Cureus, 2026 doi:10.7759/cureus.106673.
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