动脉切换手术时的年龄,大动脉转移的婴儿的大脑生长和发育之间的关联
Jessie Mei Lim1, Prashob Porayette2, Davide Marini2
1Department of Physiology (J.M.L.), University of Toronto, Canada.
Circulation
|May 29, 2019
概括
经过大动脉转移手术的婴儿在两周后经历了大脑发育受损和语言发育缓慢. 这些发现凸显了早期手术对最佳神经发育结果的重要性.
科学领域:
- 儿童心脏病学
- 神经发育儿科
- 遗传性心脏病
背景情况:
- 大动脉转移 (TGA) 与儿童大脑损伤,大脑生长受损和神经发育问题相关.
- 早期识别临床风险因素对于改善TGA婴儿的结果至关重要.
研究的目的:
- 在TGA接受动脉切换手术的婴儿中确定脑损伤和脑生长不良的临床风险因素.
- 研究18个月后这些因素与神经发育结果之间的关系.
主要方法:
- 使用磁共振成像 (MRI) 在手术前和后评估了45名婴儿的脑损伤和体积.
- 计算了大脑重量z分数,并在18个月后使用贝利-III分数评估神经发育.
- 统计分析探讨了临床变量,大脑指标和神经发育得分之间的相关性.
主要成果:
- 没有发现脑损伤的显著临床风险因素;在大多数婴儿中,脑重量z分数在手术前降低.
- 腹腔隔膜缺陷和手术时的年龄与大脑生长受损有关.
- 经过两周生命修复的婴儿在外科手术前大脑生长明显差,语言成绩较低.
结论:
- 在TGA中,手术修复延迟 (超过两周) 与大脑生长和语言发育受损有关.
- 潜在的机制包括长时间的色和影响大脑发育的肺循环过度.
- 早期手术对于优化TGA婴儿神经发育结果至关重要.
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