新生儿,婴儿和儿童的大动脉门修复:系统性审查,元分析和微模拟研究
Maximiliaan L Notenboom1, Reda Rhellab1, Jonathan R G Etnel1
1Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands.
概括
针对狭窄症的儿科大动脉修复 (AVr) 显示了令人满意的长期结果,结果因手术时的年龄而异. 尽管存在重新干预的风险,AVr对于患有大动脉病的儿童来说是一个可行的选择.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 心脏外科手术 心脏外科手术
背景情况:
- 儿童的大动脉病需要有效的治疗策略.
- 儿科大动脉修复 (AVr) 是门置换的一个替代方案.
研究的目的:
- 收集有关儿童AVr.后结果的证据.
- 支持对患有大动脉膜疾病的儿童的临床决策.
主要方法:
- 对1990年至2021年间发表的研究进行系统审查.
- 包括41个出版物,包括2623名患者和17217名患者的随访年.
- 利用微模拟模型来预测长期结果.
主要成果:
- 根据年龄不同,缩修复的早期死亡率有所不同:儿童 (3.5%),婴儿 (7.4%),新生儿 (10.7%).
- 与儿童相比,婴儿和新生儿的晚期重新干预率在婴儿和新生儿中更高.
- 在20年内,儿童的平均寿命为18.4年,婴儿为16.8年,新生儿为15.9年.
结论:
- 对于狭窄的儿科AVr产生了令人满意的长期结果,受患者在手术时的年龄的影响.
- 虽然再干预率显著,但AVr显示了较低的门相关事件发生率.
- 对于被诊断患有大动脉病的儿科患者,应考虑AVr.
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