[COVID-19 (MIS-C) 相关的儿科多系统炎症综合征患者的功能评估和随访]
Jimena Alvarado-León1, Eduardo Cifuentes-Silva1, Alejandra Encalada-Parra1
1Hospital Dr. Exequiel González Cortes, Santiago, Chile.
Andes pediatrica : revista Chilena de pediatria
|October 31, 2023
概括
在智利,患有多系统炎症综合征 (MIS-C) 的儿童经历了显著的功能障碍和情绪症状. 然而,大多数患者在出院后四个月内出现了良好的康复,尽管最初的严重程度和潜在的重症监护病房并发症.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病 传染病 传染病
- 儿科风湿病学 儿科风湿病学
背景情况:
- 与COVID-19相关的儿童多系统炎症综合征 (MIS-C) 的第一例病例于2020年6月在智利出现.
- MIS-C的长期功能序列在很大程度上是未知的,需要进一步调查.
研究的目的:
- 描述诊断为MIS-C的儿童患者在智利的一家高复杂性医院的功能状态.
- 评估退院后1个月和4个月的功能恢复.
主要方法:
- 进行了一项描述性前性研究,对28名被诊断为MIS-C的儿科患者进行了研究.
- 功能状态使用功能状态量表 (FSS),儿童残疾评估清单 (PEDI-CAT),6分钟步行测试 (6MWT),PImax,PEmax和动力测量来评估.
- 创伤后应激障碍 (PTSD) 使用儿童PTSD症状量表 (CPSS) 进行了选.
主要成果:
- 患者的平均年龄为63.6个月;60.7%没有并发症. 其中一半呈现出休克,82%有心脏干扰. 平均住院时间为9天,54%需要机械通风或血管活性药物.
- 在住院期间,82.3%的患者表现出身体变化,包括ICU获得的虚弱 (ICU-AW). 13名患者 (39.2%) 经历了情绪症状和ICU后综合征.
- 虽然58.8%的人最初具有不利的功能状态,但大多数人在四个月内恢复. 心声学异常和肌肉力量缺陷分别在1个月和4个月内得到解决. 然而,38.5%的6MWT结果低于最佳,66.6%的PTSD查结果呈阳性.
结论:
- 患有MIS-C的儿科患者经常出现显著的功能损害和情绪症状.
- 尽管最初的严重程度和潜在的重症监护室并发症,大多数患者在出院后四个月内表现出良好的功能恢复.
- 心脏功能和肌肉强度通常恢复正常,尽管持续的运动能力缺陷和潜在的创伤后压力症状需要持续监测.
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