新生儿坏死性小肠结肠炎肠造口术后高流量肠瘘预防及护理的最佳证据总结

doi:10.3761/j.issn.2096-7446.2026.05.006

摘要/Abstract

摘要：

目的总结新生儿坏死性小肠结肠炎（necrotizing enterocolitis，NEC）肠造口术后高流量肠瘘预防及护理的最佳证据，为防范肠造口术后高流量肠瘘临床实践提供依据。方法检索国内外数据库、指南网及相关专业协会网站中与新生儿NEC肠造口术后高流量肠瘘预防及护理相关的文献，检索时限为建库至2025年4月30日，对纳入文献进行质量评价、资料提取与证据汇总。结果共纳入文献17篇，其中5篇临床指南、8篇专家共识、3篇系统评价、1篇临床决策，从新生儿NEC肠造口术后高流量肠瘘评估、相关危险因素、预防护理干预措施、预防喂养措施和健康教育与随访5个方面汇总了18条最佳证据。结论该研究总结的新生儿NEC肠造口术后高流量肠瘘预防及护理的最佳证据可为临床实践提供参考依据，建议医护人员结合临床具体实际情况，制订相关护理策略。

关键词: 新生儿, 坏死性小肠结肠炎, 肠造口术, 肠瘘, 证据总结, 循证护理学

Abstract:

Objective To summarize the best evidence for the prevention and nursing care of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis，and to provide a basis for the clinical practice of preventing high-flow intestinal fistula after enterostomy. Methods The literatures related to the prevention and care of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis were retrieved from domestic and foreign databases，guideline websites and websites of relevant professional associations. The retrieval period was from the establishment of the database to April 30，2025. The quality of the included literature was evaluated，data was extracted and evidence was summarized. Results A total of 17 articles were included，including 5 clinical guidelines，8 expert consensuses，3 systematic reviews，and a clinical decision. Eighteen pieces of best evidence were summarized from five aspects，including assessment of high-flow intestinal fistula after enterostomy in neonatal necrotizing enterocolitis，related risk factors，preventive nursing intervention measures，preventive feeding measures，and health education and follow-up. Conclusion The best evidence of high-flow intestinal fistula after enterostomy summarized in this study can provide a reference for clinical practice，and it is suggested that medical staff formulate relevant nursing strategies based on the specific clinical situation.

Key words: Neonates, Necrotizing Enterocolitis, Enterostomy, Intestinal Fistula, Evidence Summary, Evidence-based Nursing

万珊珊, 陈理华, 诸纪华. 新生儿坏死性小肠结肠炎肠造口术后高流量肠瘘预防及护理的最佳证据总结[J]. 中华急危重症护理杂志, 2026, 7(5): 554-560.

WAN Shanshan, CHEN Lihua, ZHU Jihua. Summary of the best evidence for prevention and nursing of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 554-560.

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