患有先天性心脏病的幼儿发育轨迹异常的危险因素
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
概括
在患有先天性心脏病的儿童中,早期发现发育迟缓至关重要. 输液养,更多的手术和更长的住院时间与异常发育轨迹有关,
科学领域:
- 儿童心脏病学
- 儿童发育医学
- 新生儿学
背景情况:
- 患有先天性心脏病 (CHD) 的儿童面临发育迟缓的风险.
- 早期识别风险因素对于这些脆弱儿童的及时干预至关重要.
研究的目的:
- 在患有心脏病的婴儿和幼儿中确定与异常发育轨迹相关的早期风险因素.
- 为有发展迟缓高风险的儿童提供有针对性的干预信息.
主要方法:
- 在131名患有心脏病的儿童 (年龄为5. 5至37. 4个月) 中分析了527个婴儿和幼儿发育贝利尺度的长度研究.
- 用于评估影响认知,语言和运动得分轨迹的患者和临床因素的后勤回归.
- 根据得分值和随时间变化而分类为平均/改善或异常的发展轨迹.
主要成果:
- 56%的儿童在所有领域表现出平均发育;23%的儿童有单一领域的延迟,21%的儿童有多个领域的延迟.
- 与更糟糕的结果相关的因素包括更多的心脏手术,更长的住院时间,较差的线性生长和输卵管养.
- 管养成为异常发育轨迹的重要风险因素 (几率比,5. 1- 7. 9).
结论:
- 纵向发育监测有效地识别了儿童心脏病发育迟缓的早期风险因素.
- 针对可改变的因素和实施早期治疗措施可以改善高风险儿童的结果.
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