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在全腔肺连接之后,失去蛋白质的肠病和塑性支气管炎
Veronika Hammer1,2, Thibault Schaeffer1,2, Helena Staehler1,2
1Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.
World journal for pediatric & congenital heart surgery
|August 8, 2023
概括
蛋白质丧失肠病 (PLE) 和塑性支气管炎 (PB) 是全腔肺连接 (TCPC) 后的严重并发症. 占主导地位的右心室和长时间的多流增加了这些疾病的风险.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏病 手术 手术 生产性心脏病
- 胃肠病学 胃肠病学
背景情况:
- 全腔肺连接 (TCPC) 是复杂的单心室先天性心脏缺陷的缓解性手术程序.
- 已知蛋白质损失性肠病 (PLE) 和塑性支气管炎 (PB),TCPC后的严重并发症,影响患者的治疗结果.
- 了解PLE和PB的发病率,预测因素和结果对于改善TCPC患者的治疗策略至关重要.
研究的目的:
- 为了评估发病率,确定预测因素,并评估蛋白质损失肠病 (PLE) 和塑性支气管炎 (PB) 的结果,在接受全腔肺连接 (TCPC) 的患者队列中.
- 检查该患者群体中PLE或PB发病后的死亡和心脏移植的长期风险.
主要方法:
- 在1994年至2021年间连续接受TCPC治疗的620名患者的回顾性分析.
- 评估PLE/PB发病的流行率和预测因素.
- 在诊断出PLE/PB后,评估死亡率和心脏移植率.
主要成果:
- 共有41名患者 (6.6%) 患有PLE/PB,其中31名患有PLE,15名患有PB,5名患有PLE和PB.
- 开发PLE/PB的独立预测因素包括主导的右心室 (HR, 2.243) 和TCPC后的延长性肺液 (HR, 2.101).
- 在诊断后5年和10年,死亡或移植的免费率分别为88.7%和76.4%. 九名患者从PLE中恢复过来,而八人死亡.
结论:
- 失去蛋白质的肠病和塑性支气管炎在TCPC队列中仍然是显著和严重的并发症.
- 在TCPC后患有主导右心室和持续性多流的患者,患有PLE/PB的风险增加.
- 及时识别风险因素和管理策略对于改善TCPC后PLE/PB患者的长期预后至关重要.
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