Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University142110.18499/2070-478X-2020-13-4-362-370UnknownA Modern View on the Diagnosis and Treatment of Necrotizing Enterocolitis
in NewbornsKarpovaIrina Yu<p>M.D., associate Professor, Professor of the Department of pediatric surgery of the Privolzhsky Research Medical University</p>ikarpova73@mail.ruhttps://orcid.org/0000-0002-4897-6702MolchanovaDaria V<p>assistant of the Department of pediatric surgery of the Privolzhsky Research Medical University</p>dashenka8723@mail.ruLadyginaT M<p>6th year student of the pediatric faculty of the Privolzhsky Research Medical University</p>ltm9652@gmail.comPrivolzhsky Research Medical University1312202013436237025042020Copyright © 2020, Karpova I.Y., Molchanova D.V., Ladygina T.M.2020<p>The aim of the study is to present modern methods of diagnosis and treatment of necrotizing enterocolitis (NEC) in newborns.<br />According to Russian and foreign literature, up to 7.2% of newborns with NEC are admitted to intensive care units. The overall mortality rate in enterocolitis remains at the level of 15%, and in the surgical stages of the disease ranges from 26 to 31%.<br />It is known that the transferred hypoxia and asphyxia lead to vascular disorders. In addition, colonization of the intestine by pathogenic flora takes the leading place in the progression of the process.<br />In order to diagnose NEC, an overview X-ray of the abdominal organs is performed, which reveals such typical changes as: pneumatosis intestinalis, pneumoperitoneum, gastric dilatation, and the presence of a static bowel loop. Ultrasound examination of the abdominal organs confirms enterocolitis in 90% of cases. If necessary, instrumental examination findings are assessed in dynamics. Quantitative changes in the parameters of procalcitonin, calprotectin, cathelicidin, alkaline phosphadase are detected with the help of laboratory diagnostics. It is noted that TGF-1, FXIII factors, thymic index (TI), proteins (FABP2, claudin-2, GFAP) parameters vary at different stages of the disease.<br />Researchers highlight the importance of NEC prevention, a special role is given to breastfeeding. Treatment of necrotizing enterocolitis depends on the stage of the disease and the severity of symptoms, and consists of conservative therapy and surgical correction. The timeliness and necessity of prescribing antibiotics is being actively discussed. Most surgeons emphasize the therapeutic and diagnostic role of laparocentesis; the imposition of preventive intestinal stomas is considered the operation of choice. The medical periodical publications present the experience of using laparoscopy in newborns with the surgical stage of NEC. In addition to the generally accepted methods of treatment, researchers suggest options aimed at improving the clinical outcome of disease correction (vacuum therapy, the introduction of an "oxygen cocktail").</p>necrotizing enterocolitisnewbornintestinesdiagnosisrisk factorstreatmentperforationperitonitisnecrosisнекротизирующий энтероколитноворожденныйкишечникдиагностикафакторы рискалечениеперфорацияперитонитнекроз[1.Necrotic enterocolitis in the light of changes in the criteria for live birth. Razumovsky A. Yu, Polunina N. V., Savvina V. A., Yakovleva A. I., Varfolomeev A. R., Nikolaev V. N. / / Questions of practical Pediatrics, 2014, Vol. 9, No. 3, Pp. 56-59.][2. Morbidity and therapeutic and diagnostic tactics of management of newborns with ulcerative-necrotic enterocolitis Nasser M. M. A. M. / / Bulletin of medical Internet conferences, 2014. Volume 4. No. 5, P. 719][3. Necrotizing enterocolitis. 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