在后冲突地区建立高质量的儿科心脏外科手术计划:为资源有限的国家提供典范
Tammam Youssef1, Fouad Bitar2, Hassanain Alogla3
1, San Donato Milanese-Milano, Italy.
Pediatric cardiology
|January 19, 2024
概括
通过国际合作在伊拉克建立了儿科心脏手术计划,导致手术死亡率为4.1%,与全球标准相美. 这种伙伴关系模式为资源有限的国家提供了一种可持续的方法.
科学领域:
- 心血管外科心血管外科
- 全球健康 全球健康
- 儿童心脏病学 儿童心脏病学
背景情况:
- 在全球范围内,先天性心脏病 (CHD) 是婴儿死亡的主要原因.
- 在高收入国家和中低收入国家之间,手术结果存在显著差异.
- 资源有限和冲突后环境加剧了儿科心脏护理方面的挑战.
研究的目的:
- 在伊拉克建立一个高质量的儿科心脏手术项目,伊拉克是一个冲突后,资源有限的国家.
- 评估地方政府实体与国际私人组织之间的合作伙伴关系模式.
- 评估儿科心脏外科手术现场的可行性和结果.
主要方法:
- 一项描述性回顾性研究分析了148种儿科心脏手术程序.
- 从2021年10月到2022年10月,一支外科访问小组进行了手术.
- 胸腔外科医生协会 - 欧洲心胸外科协会 (STS-EACTS) 生产性心脏手术数据库 (CHSD) 复杂度评分模型 (STAT) 用于评估死亡风险.
主要成果:
- 144名患者接受了148项手术,其中婴儿占58.3%.
- 常见的诊断包括Fallot四重症,心室隔膜缺陷和单心室异常 (76%的病例).
- 整体手术死亡率为4.1%,观察到/预期死亡率为1.1 (95% CI为0.5,2.3),与STS-EACTS数据库基准没有显著差异.
结论:
- 一个涉及公共基础设施承诺和私人临床/培训服务的合作模式可以建立可持续的,高质量的儿科心脏外科手术项目.
- 这种方法对于资源有限的中高收入国家来说是可行的.
- 该计划证明了与国际标准相匹配的外科结果,同时比海外治疗更具成本效益.
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