儿童和年轻人的提取:什么时候是/系统更换的最佳时间?
Andrzej Kutarski1, Maria Miszczak-Knecht2, Monika Brzezinska2
1Department of Cardiology, Medical University of Lublin, Lublin, Poland.
Pediatric cardiology
|October 29, 2023
概括
通过静脉取 (TLE) 在儿童中在成年之前进行时更安全. 将TLE推迟到成年期会增加复杂性和风险,尽管成功率相对较高.
科学领域:
- 心脏病学 心脏病学
- 儿科电子生理学 儿科电子生理学
背景情况:
- 在儿科患者中通过静脉取 (TLE) 的管理策略仍在争论中.
- 关于儿童时期接受心脏植入式电子设备 (CIED) 的患者TLE结果的数据有限.
研究的目的:
- 为了比较TLE的困难和结果,在儿童时期接受提取 (儿童植入-儿童提取,CICE) 与在成年期接受提取 (儿童植入-成年提取,CIAE) 的患者中.
主要方法:
- 回顾性单中心研究.
- 71名CICE患者 (平均年龄15.1岁) 与114名CIAE患者 (平均年龄28.61岁) 的比较.
- 对心脏起器类型 (VVI与DDD) 的分析,植入物持续时间,手术复杂性,手术持续时间,使用先进工具和并发症率.
主要成果:
- CIAE患者的植入持续时间明显更长 (14.08 vs 7.96年),并且接受了更复杂的手术.
- CIAE患者更有可能经历延长的手术时间,并需要先进的提取工具 (2-3倍高).
- 虽然CIAE患者的主要并发症率较高 (7.0%对2.9%),但这种差异在统计学上并不显著. 临床和手术成功率在各组之间是可比的.
结论:
- 在患有儿童植入器械的患者中,延迟输血提取到成年时,与程序复杂性和风险的增加有关.
- 儿童期计划TLE可能是一个比成人期提取更安全的策略.
- 更长的植入时间是影响TLE患者安全和程序复杂性的关键因素.
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