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家庭监测计划对诺伍德手术后间期死亡率的影响
Helena Staehler1,2, Thibault Schaeffer1,2, Johanna Wasner1,2
1Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.
Frontiers in cardiovascular medicine
|October 30, 2023
概括
在诺伍德手术后,实施家庭监测计划显著降低了低可塑性左心综合征患者的间期死亡率. 这种方法可以及时进行干预,改善结果,直到双向腔肺分流程序.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 遗传性心脏病管理与管理
- 患者监测 创新 患者监测 创新
背景情况:
- 在低可塑性左心综合征 (HLHS) 中诺伍德手术的早期结果有所改善.
- 间期死亡率,即诺伍德手术和双向腔肺分流 (BCPS) 之间的时间,仍然是一个重大问题.
- 显然,需要有效的策略来减少死亡率在这个关键的间期期间是显而易见的.
研究的目的:
- 评估家庭监测计划 (HMP) 在降低HLHS患者间期死亡率方面的有效性.
- 确定与HLHS患者间期死亡率相关的风险因素.
- 分析HMP管理的患者在间期发生的事件.
主要方法:
- 分析了264名幸存于诺伍德手术并在BCPS之前出院的患者队列.
- 80名患者被纳入HMP,与HMP以外的184名患者相比,关于间期死亡率.
- 在HMP中对患者进行系统评估,对间期期间的事件进行系统评估.
主要成果:
- 与非HMP组 (10.3%) (p=0.031) 相比,HMP组的间期死亡率明显较低 (2.5%).
- 较低的出生体重,体外膜氧化支持和缺乏HMP被确定为阶段间死亡的危险因素.
- 在HMP期间常见的事件包括低和率 (18%),感染 (7.5%) 和停滞不前的体重增加 (6.3%);30%需要再入院.
结论:
- 家庭监测计划有助于及时干预,导致HLHS患者的间期死亡率显著降低.
- 很大一部分HMP患者需要重新入院,这凸显了早期第二阶段缓解治疗的重要性.
- 在复杂的先天性心脏病中,HMP是改善复杂先天性心脏病间期结果的宝贵工具.
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