一种新的综合临床-生物化学-放射学和超声波分类,用于死性肠球炎的分类
Yasser Elsayed1, Deepak Louis1, Martha Hinton2
1Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
American journal of perinatology
|January 11, 2024
概括
新生儿科医生进行的肠道超声波 (NP-IUS) 与临床和实验室标记器相结合,可以准确诊断出需要干预的死性肠球炎 (NEC). NP-IUS在识别需要手术的NEC方面表现出高灵敏度.
科学领域:
- 新生儿医学 新生儿医学
- 儿科胃肠病学 儿科胃肠病学
- 诊断成像诊断成像的使用
背景情况:
- 死性肠球炎 (NEC) 是早产新生儿的一种严重疾病.
- 准确的诊断对于及时和适当的治疗干预至关重要.
- 现有的诊断方法在灵敏度和特异性方面存在局限性.
研究的目的:
- 评估临床,实验室,放射学标志物和新生儿科医生进行的肠道超声波 (NP-IUS) 的诊断性能,用于需要干预的NEC.
- 为了确定NP-IUS与其他标记器相比的灵敏度和特异性.
主要方法:
- 一项涉及早产新生儿 (<35周) 的病例控制研究,怀疑NEC.
- 诊断工作包括NP-IUS,腹部X光学图 (AXR) 和实验室测试.
- IUS标记被标准化,AXR独立阅读,IUS解释者对结果被蒙蔽.
主要成果:
- 一个综合模型结合了超声波标记,临床不稳定性,腹部纤维炎和CRP>16 mg/L,显示AUC为0.89,用于诊断需要手术的NEC.
- 贝尔分类的AUC为0.74,用于诊断需要手术或死亡的NEC.
- NP-IUS是NEC需要手术干预的最敏感标志物.
结论:
- 特定的IUS标记物,临床症状和实验室标记物的组合用于诊断需要干预的NEC.
- 当被训练有素的新生儿科医生进行NP-IUS时,它是诊断需要手术干预的NEC的高度敏感工具.
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