在患有死角性肠球炎的患者中进行后出血性水脑病的管理:一个单心经验
Martina Monti1,2, Gloria Mandrile3,4, Gianluca Piatelli5
1Pediatric Surgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. martinamonti3194@gmail.com.
概括
管理早产婴儿患有后出血性水头发症和死性肠球炎是复杂的. 不建议在亚临床死性肠球炎中插入分离器,以防止并发症.
科学领域:
- 新生儿科学 新生儿科学
- 儿科神经外科 儿科神经外科
- 胃肠病学 胃肠病学
背景情况:
- 后出血性水脑炎 (PHH) 和死性肠球炎 (NEC) 是早产婴儿的重要并发症.
- 同时管理PHH和NEC带来了独特的临床挑战.
- 早期干预至关重要,以防止脑膜炎和多局部水脑炎等严重后果.
研究的目的:
- 评估早产婴儿的结果,包括PHH和NEC.
- 在这个患者群体中评估与心室关节突变插入相关的风险.
- 为了确定最佳的管理策略,同时发生的PHH和NEC.
主要方法:
- 2012-2022年对19名患有NEC和PHH的患者进行了一项单一中心的回顾性研究.
- 对围产,成像和NEC相关数据的评估.
- 在分离器插入后12个月内,分离器阻塞,感染和死亡率的文件.
主要成果:
- 这项研究包括19名早产婴儿 (中位妊娠年龄26周,中位出生体重880克).
- 腹腔内出血和腹腔扩张很常见 (分别为73.68%和78.95%).
- 败血症是普遍存在的 (78.95%),有4例与NEC相关的分流感染,其中3例是亚临床NEC;31.58%经历了精神运动延迟,没有死亡报告.
结论:
- 认出亚临床NEC是困难的,但至关重要.
- 在患有并发性亚临床NEC的患者中不建议插入 Ventriculoperitoneal shunt.
- 应探索替代管理策略,以减轻脑膜炎和变送器功能障碍的风险.
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