生まれつきの心臓病の幼児における異常な発達経路の危険因子
Kathleen A Mussatto1, Raymond Hoffmann2, George Hoffman2
1From Herma Heart Center, Children's Hospital of Wisconsin, Milwaukee (K.A.M., J.T.); and Departments of Pediatrics (R.H., L.B., Y.C., C.B.), Anesthesiology (G.H.), and Surgery (J.S.T.), Medical College of Wisconsin, Milwaukee. kmussatto@chw.org.
Circulation
|August 26, 2015
まとめ
生まれながらの心臓病の子供の発達遅延の早期発見は極めて重要です. チューブで餌を与えることや 手術の頻度や 長期間の入院は 異常な発達経路と関連しており 重要な危険因子を示しています
科学分野:
- 小児心臓科
- 発達に関する小児科
- 新生児科
背景:
- 生まれながらの心臓病 (CHD) を患っている子供は,発達遅延のリスクが高くなります.
- 危険因子を早期に特定することは,これらの脆弱な子供への適切な介入に不可欠です.
研究 の 目的:
- 乳幼児と幼児の異常な発達経路に関連した早期の危険因子を特定する.
- 発達の遅延のリスクの高い子供に対する 標的型介入の情報提供
主な方法:
- 乳児と幼児の発達に関するベイリースケール第3版の527件の評価を131人の心臓病患者 (5. 5~37. 4ヶ月) で分析した長期的研究.
- 認知,言語,運動スコア軌道に影響を与える患者および臨床的要因を評価するために使用されるロジスティック回帰.
- スコアの値と時間の経過による平均/改善または異常と分類された発達経路.
主要な成果:
- 56%の子供は全ての領域で平均的な発達を示し,23%は単一領域の遅延,21%は複数の領域の遅延を示した.
- より悪い結果につながった要因には より多くの心臓手術,より長い入院,より低い線形成長,およびチューブ栄養が含まれています.
- 管の餌は異常な発達経路の重要な危険因子として浮上した (オッズ比,5. 1- 7. 9).
結論:
- 長期的発達監視は,心臓病の発達遅延の早期の危険因子を効果的に特定します.
- 修正可能な要因を標的とし 早期の治療介入を実施することで 高いリスクを持つ子供たちの 結果を改善できます
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