新生儿肠道穿孔:什么时候应该进行直肠活检以排除赫施普朗格病?
Özlem Balcı1, Ayşe Karaman1, Aslı Nur Abay1
1Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
Journal of laparoendoscopic & advanced surgical techniques. Part A
|November 18, 2025
概括
赫施普隆病 (Hirschsprung's disease,简称HD) 是新生儿肠道穿孔 (IP) 的关键原因,不仅仅是死性肠球炎 (NEC). 结直肠活检对于在非NEC IP病例中诊断HD是有价值的,特别是在有结肠穿孔的预产婴儿中.
科学领域:
- 新生儿手术 新生儿手术
- 儿科胃肠病学 儿科胃肠病学
- 手术病理学的外科病理学
背景情况:
- 肠道穿孔 (IP) 是一个关键的新生儿手术紧急情况,通常与死角性肠球炎 (NEC) 或希尔施普朗格病 (HD) 相关.
- 调查IP的非NEC原因对于准确的新生儿诊断和管理至关重要.
研究的目的:
- 确定非NEC肠道穿孔 (IP) 的新生儿中希尔施普朗格病 (HD) 的发生频率.
- 评估直肠活检在这些患者中识别HD的诊断效用.
主要方法:
- 从2005年到2021年,对新生儿进行非NECIP治疗的回顾性分析.
- 收集和比较人口,临床,手术和直肠活检数据.
- 检查直肠活检的组织病理学分析,以确定腺结核病.
主要成果:
- 在48名非NEC IP的新生儿中进行了直肠活检;12.5%的新生儿显示出腺瘤 (HD).
- 结节性病例的妊娠年龄更高 (36.7 vs 32.5 周) 并且仅有结肠穿孔.
- 满期新生儿和结肠穿孔的新生儿更有可能患有潜在的HD.
结论:
- 在未由NEC引起的新生儿肠穿孔 (IP) 的差异诊断中,应考虑赫施普隆病 (HD).
- 对于非NEC IPs,特别是预产期新生儿和结肠穿孔的新生儿,建议进行直肠活检,以检测结膜炎.
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