Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS)
Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS)
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DOI：
10.1016/j.siny.2019.01.009
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发表时间：
2019-04-01
影响因子：
3
通讯作者：
Kraft, W. K.
中科院分区：
文献类型：
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作者：
Mangat, A. K.;Schmolzer, G. M.;Kraft, W. K.
新生儿戒断综合征是指母亲宫内药物暴露后婴儿出现的戒断症状和体征。所有有记录的宫内阿片类药物暴露或高试验前暴露概率的婴儿都应使用标准评估工具（如Finnegan评分）进行监测。Finnegan评分> 8表明阿片类药物暴露，即使在怀孕期间没有申报使用。在大多数地区，至少有一半的婴儿可以在不使用药物的情况下治疗。出于这个原因，症状评分将驱动药物治疗的决定。然而，所有婴儿，无论最初表现如何，都应首先使用非药物方法进行管理，而非药物方法不应被视为药物治疗的唯一替代方案，而是作为所有患者治疗的基础。那些尽管接受了支持性治疗但仍有症状的人应该接受对症治疗，在最严重的情况下，这是可以挽救生命的。
Neonatal abstinence syndrome is defined by signs and symptoms of withdrawal that infants develop after intrauterine maternal drug exposure. All infants with documented in utero opioid exposure, or a high pre-test probability of exposure should have monitoring with a standard assessment instrument such as a Finnegan Score. A Finnegan score of > 8 is suggestive of opioid exposure, even in the absence of declared use during pregnancy. At least half of infants in most locales can be treated without the use of pharmacologic means. For this reason, symptom scores will drive the decision for pharmacologic therapy. Nevertheless, all infants, regardless of initial manifestations, should be first be managed with non-pharmacologic approaches which in turn, should not be considered as the sole alternative to drug therapy, but rather, as the base upon which all patients are treated. Those who continue to have symptoms despite supportive care should be pharmacologically treated, which in the most severe cases, is life-saving.