新生儿和婴儿的二次卡尼丁缺乏症需要为肠道阻塞进行手术 - - 一个被低估和管理不足的问题
Sheng-Yang Huang1,2,3, Chia-Man Chou1,2,3, Hou-Chuan Chen1
1Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
Children (Basel, Switzerland)
|February 24, 2024
概括
卡尼丁缺乏与患有肠道阻塞的婴儿的长时间内有关. 通过MS/MS或尿液有机酸分析及卡尼丁替代疗法的早期诊断可以改善结果.
科学领域:
- 儿科手术 儿科手术
- 营养生物化学 营养生物化学
- 新生儿医学 新生儿医学
背景情况:
- 肠道阻塞是新生儿和婴儿的危急情况.
- 卡尼缺乏症是一种代谢障碍,具有潜在的全身影响.
- 在这个年龄段,肠道阻塞和肉素缺乏之间的关联需要进一步调查.
研究的目的:
- 为了调查患有肠道阻塞的婴儿中肉素缺乏症的流行情况.
- 确定卡尼丁缺乏对肠道阻塞的呈现和恢复的临床影响.
- 评估卡尼丁替代疗法在受影响的婴儿中的疗效.
主要方法:
- 对330名因肠道阻塞而接受手术的婴儿 (<6个月) 的医疗记录的回顾性审查.
- 对临床数据,并发症和病因学的分析.
- 在47名患者中,生物化学分析 (MS/MS或尿液有机酸) 检测卡尼丁缺乏.
主要成果:
- 在47名分析患者中,16名患者 (34.0%在可疑组,4.8%整体) 发现了卡尼丁缺乏症.
- 与没有 (平均10.8天) 的患者相比,卡尼丁缺乏症患者表现出显著延长的内脏 (平均41.7天).
- 在12名患者的卡尼丁替代疗法显示出潜在的益处,其中有一例轻度药物过敏.
结论:
- 卡尼丁缺乏是新生儿和婴儿肠道阻塞的一个重要,未被认可的因素.
- 建议使用MS/MS或尿液有机酸分析查卡尼丁缺乏症,对于患有长期内的婴儿.
- 卡尼丁替代疗法是一种可行的,对受影响的婴儿有潜在益处的治疗方法.
相关概念视频
01:19Depolarizing Blockers: Pharmocokinetics
326
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
326
01:31Skeletal Muscle Relaxants: Therapeutic Uses
486
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
486
01:21Skeletal Muscle Relaxants: Adverse Effects
372
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
372