在5岁以下的儿童进行机械 mitra 置换后,假肢存活,生长和功能状况的预测因素,多机构研究
Geetha Raghuveer1, Christopher A Caldarone, Christine B Hills
1Department of Pediatrics, University of Kansas Medical Center, 3901, Rainbow Blvd., Kansas City, KS 66160, USA. graghuveer@kumc.edu
Circulation
|September 13, 2003
概括
在幼儿 (<5岁) 中,机械门置换 (MVR) 显示出基于年龄和假肢尺寸的可预测生存率. 大多数儿童保持良好的功能状态,体生长不受重复MVR的影响.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
背景情况:
- 在5岁以下的儿童中,机械关置换 (MVR) 的结果尚未得到充分证实.
- 关键因素如假肢存活,体质生长和功能状态需要进一步定义.
研究的目的:
- 分析长期假肢存活率,体生长和5岁以下儿童初始MVR后的功能状态.
- 确定与第二次MVR需要相关的风险因素.
主要方法:
- 儿童心脏护理联盟对102名接受初始MVR (1982-1999) 的儿童进行了回顾性分析.
- 平均随访时间为6.0年,完成率为96%.
- 使用人口统计学和外科外科变量,比较需要第二次MVR的患者 (n=29) 与不需要第二次MVR的患者 (n=73).
主要成果:
- 假肢存活率是由初始MVR年龄 (OR 7.7) 和假肢大小 (OR 6.8) 预测的.
- 高风险患者 (年龄小于2岁,假肢小于20毫米) 需要第二次MVR的风险增加了46.3倍.
- 实体生长在两组之间是相似的,但第二个MVR患者获得了较小的初始假肢.
- 76%的患者在MVR后具有纽约心脏协会 (NYHA) 1级功能状态.
结论:
- 初始MVR年龄和假肢大小是儿科患者假肢生存的关键预测因素.
- 机械关节置换在幼儿中是一个可行的策略,尽管最年轻的孩子有重新手术的风险增加.
- 在第二次MVR时,假肢尺寸增加表明持续的环状生长,功能结果通常是有利的.
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