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

Abstract

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

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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References 30

[1]	中国医师协会新生儿科医师分会循证专业委员会. 新生儿坏死性小肠结肠炎临床诊疗指南(2020)[J]. 临床医学研究与实践, 2021, 6(2):201.
	Evidence-Based Medicine Group,Neonatologist Society,Chinese Medical Doctor Association. Clinical diagnosis and treatment guidelines for neonatal necrotizing enterocolitis(2020)[J]. Clin Res Pract, 2021, 6(2):201.
[2]	中华医学会小儿外科分会新生儿外科学组. 新生儿坏死性小肠结肠炎外科手术治疗专家共识[J]. 中华小儿外科杂志, 2016, 37(10):724-728.
	The Group of Neonatal Surgery,Pediatric Surgical Society,Chinese Medical Association. Expert consensus on surgical treatment of neonatal necrotizing enterocolitis[J]. Chin J Pediatr Surg, 2016, 37(10):724-728.
[3]	中华医学会小儿外科学分会新生儿学组. 新生儿坏死性小肠结肠炎小肠造瘘术后临床治疗专家共识[J]. 中华小儿外科杂志, 2016, 37(8):563-567.
	The Group of Neonatology,Pediatric Surgical Society,Chinese Medical Association. Expert consensus on postoperative intestinal stoma of neonatal necrotizing enterocolitis[J]. Chin J Pediatr Surg, 2016, 37(8):563-567.
[4]	Kim JH. Neonatal necrotizing enterocolitis:management and prognosis[EB/OL]. (2023-05-09)[2025-02-08]. https://www.uptodate.cn/contents/neonatal-necrotizing-enterocolitis-management-and-prognosis.
[5]	Jones IH, Hall NJ. Contemporary outcomes for infants with necrotizing enterocolitis-a systematic review[J]. J Pediatr, 2020, 220:86-92.e3. doi: 10.1016/j.jpeds.2019.11.011
[6]	林土连, 吴强, 彭艳芬, 等. 新生儿坏死性小肠结肠炎肠造瘘术后造口高流量腹泻的相关因素分析[J]. 临床小儿外科杂志, 2022, 21(4):310-314.
	Lin TL, Wu Q, Peng YF, et al. Risk factors of high-output stoma after enterostomy in necrotizing enterocolitis[J]. J Clin Pediatr Surg, 2022, 21(4):310-314.
[7]	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21):1991-1994.
	Zhu Z, Hu Y, Xing WJ, et al. The composition of different types of evidence based problems[J]. J Nurses Train, 2017, 32(21):1991-1994.
[8]	Dicenso A, Bayley L, Brian Haynes R. Accessing pre-appraised evidence:fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009, 12(4):99-101. doi: 10.1136/ebn.12.4.99-b pmid: 19779069
[9]	Hoffmann-Eßer W, Siering U, Neugebauer EAM, et al. Guideline appraisal with AGREE Ⅱ:online survey of the potential influence of AGREE Ⅱ items on overall assessment of guideline quality and recommendation for use[J]. BMC Health Serv Res, 2018, 18(1):143. doi: 10.1186/s12913-018-2954-8 pmid: 29482555
[10]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018.
	Hu Y, Hao YF. Evidence-based nursing[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2018.
[11]	Pieper D, Buechter RB, Li L, et al. Systematic review found AMSTAR,but not R(evised)-AMSTAR,to have good measurement properties[J]. J Clin Epidemiol, 2015, 68(5):574-583. doi: 10.1016/j.jclinepi.2014.12.009 pmid: 25638457
[12]	李敏敏, 司在霞, 刘进, 等. 早产儿喂养不耐受预防及管理的最佳证据总结[J]. 中华护理杂志, 2020, 55(8):1163-1168. doi: 10.3761/j.issn.0254-1769.2020.08.007
	Li MM, Si ZX, Liu J, et al. Evidence summary for prevention and management of feeding intolerance in preterm infants[J]. Chin J Nurs, 2020, 55(8):1163-1168. doi: 10.3761/j.issn.0254-1769.2020.08.007
[13]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
	Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train, 2015, 30(11):964-967.
[14]	Ergenekon E, Tayman C, Özkan H. Turkish neonatal society necrotizing enterocolitis diagnosis,treatment and prevention guidelines[J]. Turk Arch Pediatr, 2021, 56(5):513-524. doi: 10.5152/TurkArchPediatr.
[15]	中国造口管理协作组, 中华护理学会伤口造口失禁护理专业委员会, 中国医师协会外科医师分会结直肠医师专业委员会, 等. 肠造口并发症的分型与分级标准(2023版)[J]. 中华胃肠外科杂志, 2023, 26(10):915-921.
	The Chinese Ostomy Collaboration Group, Wound,Ostomy,and Continence Nursing Committee of Chinese Nursing Association, Colon and Rectal Surgeon Committee of Surgeon Branch of Chinese Medical Doctor Association, et al. Criteria of enterostomy complications:classification and grading(2023 edition)[J]. Chin J Gastrointest Surg, 2023, 26(10):915-921.
[16]	Stoop TF, van Bodegraven EA, Ten Haaft BHEA, et al. Systematic review on management of high-output enterostomy in children:an urgent call for evidence[J]. J Pediatr Gastroenterol Nutr, 2024, 78(2):188-196. doi: 10.1002/jpn3.v78.2
[17]	Norsa L, Goulet O, Alberti D, et al. Nutrition and intestinal rehabilitation of children with short bowel syndrome:a position paper of the ESPGHAN committee on nutrition. part 2:long-term follow-up on home parenteral nutrition[J]. J Pediatr Gastroenterol Nutr, 2023, 77(2):298-314. doi: 10.1097/MPG.0000000000003850
[18]	Norsa L, Goulet O, Alberti D, et al. Nutrition and intestinal rehabilitation of children with short bowel syndrome:a position paper of the ESPGHAN committee on nutrition. part 1:from intestinal resection to home discharge[J]. J Pediatr Gastroenterol Nutr, 2023, 77(2):281-297. doi: 10.1097/MPG.0000000000003849
[19]	曹云, 李正红, 韩树萍, 等. 新生儿重症监护室母乳使用专家共识[J]. 中国循证儿科杂志, 2021, 16(3):171-178.
	Cao Y, Li ZH, Han SP, et al. Expert consensus on breast milk use in neonatal intensive care unit[J]. Chin J Evid Based Pediatr, 2021, 16(3):171-178.
[20]	中国医师协会新生儿科医师分会循证专业委员会. 早产儿喂养不耐受临床诊疗指南(2020)[J]. 中国当代儿科杂志, 2020, 22(10):1047-1055.
	Evidence-Based Medicine Group,Neonatologist Society,Chinese Medical Doctor Association. Clinical guidelines for the diagnosis and treatment of feeding intolerance in preterm infants(2020)[J]. Chin J Contemp Pediatr, 2020, 22(10):1047-1055.
[21]	早产儿母乳强化剂使用专家共识工作组, 中华新生儿科杂志编辑委员会. 早产儿母乳强化剂使用专家共识[J]. 中华新生儿科杂志(中英文), 2019, 34(5):321-328.
	Experts Working Group on Consensus on the Use of Human Milk Fortifier in Preterm Infants, Editorial Board Committee of Chinese Journal of Neonatology. Consensus on the use of human milk fortifier for preterm infants[J]. Chin J Neonatol, 2019, 34(5):321-328.
[22]	Davis BR, Valente MA, Goldberg JE, et al. The American society of colon and rectal surgeons clinical practice guidelines for ostomy surgery[J]. Dis Colon Rectum, 2022, 65(10):1173-1190. doi: 10.1097/DCR.0000000000002498 pmid: 35616386
[23]	国家儿童医学中心首都医科大学附属北京儿童医院, 《中华新生儿科杂志》编辑委员会, 中国医师协会新生儿科医师分会生命支持学组. 新生儿肠造瘘术后营养支持实践指南(2024版)[J]. 中华新生儿科杂志(中英文) 2024 39(6):321-331.
	Capital Medical University,National Center for Children’s Health, Editorial Board of Chinese Journal of Neonatology, Life Support Group in Neonatologist Subdivision of Chinese Medical Doctor Association. Clinical guideline for post-operational nutrition support of neonates with enterostomy(2024)[J]. Chin J Neonatol, 2024, 39(6):321-331.
[24]	林新祝, 李正红, 常艳美, 等. 早产儿肠内营养管理专家共识(2024年)[J]. 中国当代儿科杂志, 2024, 26(6):541-552.
	Lin XZ, Li ZH, Chang YM, et al. Expert consensus on enteral nutrition management of preterm infants(2024)[J]. Chin J Contemp Pediatr, 2024, 26(6):541-552.
[25]	Bhat S, Cameron NR, Sharma P, et al. Chyme recycling in the management of small bowel double enterostomy in pediatric and neonatal populations:a systematic review[J]. Clin Nutr ESPEN, 2020, 37:1-8. doi: 10.1016/j.clnesp.2020.03.013
[26]	Trivedi A, Teo E, Walker KS. Probiotics for the postoperative management of term neonates after gastrointestinal surgery[J]. Cochrane Database Syst Rev, 2024, 1(1):CD012265.
[27]	Shah D, Sinn JK. Antibiotic regimens for the empirical treatment of newborn infants with necrotising enterocolitis[J]. Cochrane Database Syst Rev, 2012,(8):CD007448.
[28]	李继承, 杜娟, 杨子馨, 等. 早发型坏死性小肠结肠炎肠造瘘患儿临床特征及术后并发症危险因素分析[J]. 中华医学杂志, 2024, 104(1):38-44.
	Li JC, Du J, Yang ZX, et al. Analysis of clinical characteristics and risk factors of postoperative complications in infants with early-onset necrotizing enterocolitis after enterostomy[J]. Natl Med J China, 2024, 104(1):38-44.
[29]	金婷, 徐红贞, 唐芳, 等. 新生儿肠造口护理的研究进展[J]. 中华急危重症护理杂志, 2022, 3(1):36-40.
	Jin T, Xu HZ, Tang F, et al. A review of neonatal enterostomy nursing[J]. Chin J Emerg Crit Care Nurs, 2022, 3(1):36-40.
[30]	吴金花, 倪志红, 赵雪萍, 等. 肠造口新生儿家长照护体验的质性研究[J]. 中华护理杂志, 2021, 56(11):1627-1633. doi: 10.3761/j.issn.0254-1769.2021.11.004
	Wu JH, Ni ZH, Zhao XP, et al. Caring experiences of parents of neonates with enterostomy:a qualitative study[J]. Chin J Nurs, 2021, 56(11):1627-1633.

Summary of the best evidence for prevention and nursing of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis

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