静脉门和静脉关突功能障碍和感染的婴儿与死性肠球炎
Katherine G Holste1, Jack Vernamonti2, Momodou G Bah3
11Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
Journal of neurosurgery. Pediatrics
|August 5, 2023
概括
在患有死角性肠球炎 (NEC) 的婴儿中,心室膜 (VP) 突变显示出比心室膜 (VA) 突变更长的失效时间. 感染率相似,这表明VP分流可能是这些患者的可行选择.
科学领域:
- 儿科神经外科 儿科神经外科
- 新生儿医学 新生儿医学
- 外科手术的结果
背景情况:
- 结核性肠球炎 (NEC) 和后出血性水脑炎是影响早产婴儿的关键疾病.
- 腹突变是水头症的首选,但NEC历史引起了人们对突变并发症的担忧.
- 由于与NEC相关的感知风险,有时会使用替代的分离术语.
研究的目的:
- 为了比较患有NEC病史的儿科患者的心室内腔 (VA) 和心室内皮层 (VP) 路由器感染和失败率.
- 在这个高风险人群中评估不同类型的分流系统的安全性和有效性.
主要方法:
- 对22名患有NEC的儿科患者进行了回顾性审查,这些患者在两岁之前接受了分离器安置.
- 收集的数据包括分离器类型,NEC管理,感染,修订和故障率.
- 统计分析使用学生t测试,费舍尔精确测试和卡普兰-梅尔曲线.
主要成果:
- 腹腔关节 (VP) 突变更为常见 (71.4%).
- 在VA和VP分离器之间,分离器感染率相似 (p=0.7).
- 静脉静脉 (VA) 突变的修订率显著更高 (83%对31%) 和失败时间更短 (3.0对46.3个月).
结论:
- 与先前有NEC的婴儿的VA分流相比,VP分流的失败时间显著更长.
- 在这两种突变型之间,感染率是可比的.
- 当可能时,神经外科医生可能会考虑在有NEC病史的患者中进行VP切换.
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