通过皮肤进行的囊性排与胎儿下尿道阻塞 (PLUTO) 的保守治疗:一项随机试验
Rachel K Morris1, Gemma L Malin, Elisabeth Quinlan-Jones
1School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Fetal Medicine Centre, Birmingham Women's Hospital NHS Foundation Trust, Edgbaston, Birmingham, UK.
Lancet (London, England)
|August 20, 2013
概括
对于胎儿下泌尿道阻塞 (LUTO) 的阴囊膜分流可能会改善存活率,但证据仍然不确定. 长期的功能不良,无论对LUTO的治疗如何.
科学领域:
- 产周医学 产周医学
- 胎儿外科手术 胎儿外科手术
- 新生儿结局的结果.
背景情况:
- 胎儿下尿道阻塞 (LUTO) 导致显著的围产期死亡率和长期发病率.
- 有效的LUTO治疗对于改善婴儿结局至关重要.
研究的目的:
- 为了评估囊膜切换在治疗隔离胎儿LUTO时的有效性.
- 评估轮流切割对新生儿存活率和长期功能的影响.
主要方法:
- 一个随机试验涉及怀孕与孤立的LUTO.
- 黄囊膜转移与保守管理的比较.
- 处理意图和处理分析,包括贝叶斯方法.
主要成果:
- 该研究因招募不善 (31名参与者) 而提前结束.
- 对治疗意图的分析显示,随着分流,28天生存率的非显著增加 (RR1.88,p=0.27).
- 随处理的分析表明有显著的益处 (RR 3.20,p=0.03);然而,只有2/16的分流新生儿在2岁时具有正常的功能.
结论:
- 阴囊膜切换可能会增加LUTO的存活率,但效应的大小和确定性仍然不清楚.
- 新生儿的存活率与正常的功能是低的,不管LUTO的变流.
相关概念视频
Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...


