《论文新生儿坏死性小肠结肠炎》ppt课件.pptxVIP

Neonatal necrotizing enterocolitis Kunyao Yu Outline Risk factor Bacterial NEC Intestinal defense mechanism Clinical presentation Bell’s stage Treatment Risk Factor Premature Low birth weight(1500g) Broad-spectrum antibiotics Feeding Bacterial NEC Intestinal bacterial colonization in the infant -Delivery method -Feeding Delivered vaginally Delivered via cesarean section Bacterial Colonization Lactobacillus, Prevotella, Sneathia Staphylococcus, Corynebacterium, Propionibacterium Breast-fed Formula-fed Bacterial Colonization Bifidobacterium, Lactobacillus,Streptococcus Bifidobacterium, Staphylococcus, Escherichia coli, Clostridia Intestinal defense mechanism Peristalsis Gastric acid Proteolytic enzymes Intestinal mucus Cell surface glycoconjugates Cell’s tight junctions Immunology Clinical presentation Abdominal sign: distension, vomiting, hematochezia Feeding intolerance Lethargy Temperature instability Hypotension Image Bell’s stage Treatment Stage Ia: -NPO Stage Ib-IIb/IIIa: -NPO -Broad spectrum antibotics Stage IIIa-IIIb: -Surgery/Peritoneal drain Probiotics-treat? Probiotics-treat? What is the optimal probiotic organism(s)? What is the optimal administration including assessment of what patients are the best candidates for treatment? What is the optimal probiotic dose? What is the best timing of administration? What is the most efficacious length of treatment? THANK YOU