Necrotizing Enterocolitis (NEC)
Nekrotizujúca enterokolitída (NEC)
Ciefom práce je prezentovat chirurgický prístup v liečbe novorodencov s nekrotizujúcou enterokolitídou. Pacienti a metodika: 5úbor tvori 14 novorodencov s NEC Bečených na Jednotke intenzívnej starostlivosti Kliniky detskej chirurgie v Bratislave v rokoch 1996 - 1999. V diagnostike a liečbe autori používajú Bellovu klasifikáciu. U pacientov sa zamerali na rizikové faktory a chirurgický prístup v liečbe.Výsledky: Dvaja pacienti bolí v I. štádiu ochorenia, jedného z nich autori operovali z diferenciálne diagnostických príčin a druhého liečili konzervatívne. V II. štádiu ochorenia 3 pacientov liečili konzervatívne. V IiI. štádiu 7 pacientov operovali a 2 liečili konzervatívne. 2 pacienti zo súboru exitovali. Spolu autori operovali 8 pacientov. U viičšiny novorodencov (6) vykonali resekciu postihnutého úseku čreva a enterostómiu. Následný uzáver stomie vykonali elektívne v priemere o 5 mesiacov neskór, s dobrým výsledkom. V práci bližšie analyzujú načasovanie a typ zákroku.Záverom autori konštatujú, že kfúčom k dobrým výsledkom je včasné rozpoznanie nešpecifických príznakov NEC. Úloha chirurga spočíva v správnom načasovaní vhodného zákroku. V našich podmienkach sa javí bezpečnou a efektívnou metodikou viacetapová operácia s prechodnou enterostomiou.
Klíčová slova:
nekrotizujúca enterokolitída, novorodenec, chirurgická liečba
Authors:
F. Horn; J. Babala; Š. Studený; P. Valentík; B. Geryk; J. Siman
Authors‘ workplace:
Klinika detskej chirurgie LFUK, Detská fakultná nemocnica s poliklinikou, Bratislava, prednosta prof. MUDr. J. Siman, CSc.
Published in:
Čes-slov Pediat 2002; (1): 8-11.
Category:
Overview
The aim of the study is to present the procedure and results of treatment of patients with neonatal necrotising enterocolitis (NEC).Patients and method: In 1996 - 1999 14 neonates with NEC were admitted to the Intensive care uvit of the Department of Paediatric 5urgery in Bratislava. For staging authors use Bell's classification. In the group of patients authors evaluated the risk factors and focused on the surgical approach to the treatment.Results: Two patients were in stage I, one was operated (diff. dg) and one was treated conservatively with good results. Three patients were in stage II, all of them were treated conservatively with good results. Nine patients were in stage III, seven of them were operated and two were treated conservatively. Two patients died. 8 patients were operated. In most of our patients (6) authors performed resection of the involved bowel and enterostomy. The occlusion of the enterostomy was elective on average after 5 months, with good results. In the presentation authors discuss the timing and type of surgery used in their patients.Conclusion: The key to the improved results seems to be early recognition of the non-specific signs. The role of the surgeon is in the optimal timing of any possible interventional procedure. Under their conditions a two or more stage repair with enterostomy seems to be a Bafe approach in the treatment of patients with NEC.
Key words:
necrotising enterocolitis, neonate, surgical treatment
Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2002 Issue 1
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