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穿管的放置缩短了在左先天性隔膜的完全养的时间
Ana Herranz Barbero1, Isabel Iglesias-Platas2, Jordi Prat-Ortells3
1Neonatology Department, Hospital Clínic, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, University of Barcelona, C/ Sabino Arana 1, 08028, Barcelona, Spain.
Journal of pediatric surgery
|July 28, 2023
概括
转皮养 (TPT) 缩短了新生儿左先天性腹膜 (L-CDH) 完全肠道营养的时间. 这种方法对严重的L-CDH病例特别有益,可能改善结果.
科学领域:
- 新生儿手术 新生儿手术
- 儿科胃肠病学 儿科胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 营养并发症显著影响先天性隔膜 (CDH) 患者的短期和长期发病率.
- 优化营养支持对于改善CDH新生儿的结果至关重要.
研究的目的:
- 为了比较左侧CDH (L-CDH) 的新生儿在胃 (GT) 和透 (TPT) 路径之间实现全肠管养的时间.
- 评估食路线对营养支持持续时间和胃肠道并发症的影响.
主要方法:
- 追溯队列研究,包括从2007年1月至2014年12月入住第三级护理NICU的L-CDH患者.
- 排除标准包括致命的染色体异常和在开始肠道营养之前的死亡.
- 数据分析比较了GT和TPT组之间的全肠养时间,亲肠养的持续时间和胃肠道问题的发生率.
主要成果:
- TPT组在11.0天内实现了全肠道养,而GT组在16.8天内实现了 (p=0.041).
- 由于胃肠道问题,TPT患者的禁食日数较少 (3.9天与11.4天相比,p=0.028),肠道营养率下降的发作较少.
- 多变量分析表明,根据临床因素调整后,TPT养的婴儿比GT养的婴儿早8.4天获得了全肠养 (p<0.001).
结论:
- 透皮养 (TPT) 显著缩短了新生儿左先天性隔膜 (L-CDH) 实现全肠营养的时间.
- 对于更严重的L-CDH病例来说,TPT食特别有利.
- 建议在手术修复结束时考虑放置TPT管,特别是在风险较高的L-CDH患者中.
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