儿童多系统炎症综合征:一个雨审查
Naohiro Shioji1, Makoto Sumie2,3,4,5, Marina Englesakis6
1Department of Anesthesiology and Intensive Care Medicine, National Cancer Center Hospital, Tokyo, Japan.
Journal of anesthesia
|March 26, 2024
概括
这一对儿童多系统炎症综合征 (MIS-C) 的综合性综述发现了高的ICU入院率,并确定了有效的治疗方法,如用葡萄糖皮质激素治疗IVIG. 未来的研究应该专注于MIS-C患者的外科安全性和长期结果.
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
- 系统性审查和元分析.
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 在COVID-19大流行期间出现.
- 了解MIS-C患者的特征对于指导未来的研究和临床管理至关重要.
- 之前的系统性审查已经探讨了MIS-C的各个方面,需要进行总体审查来综合发现.
研究的目的:
- 对MIS-C进行系统性审查和元分析进行总体审查.
- 为了识别MIS-C研究中研究的患者特征.
- 为MIS-C.指导未来的研究方向.
主要方法:
- 在 MEDLINE,EMBASE 和 Cochrane 图书馆进行了全面的文献搜索 (2019年12月 - 2022年5月).
- 包括从2020年起出版的儿童MIS-C (≤21岁) 系统审查或元分析.
- 对41项符合条件的研究进行定性分析,其中28项报告了结果数据.
主要成果:
- 患有MIS-C的死亡率为1.9% (IQR为0.48),ICU入院率为72.6% (IQR为8.3),体外膜氧化率为4.7% (IQR为2.0).
- 与COVID-19患者相比,MIS-C患者的脑内天然尿素水平较高.
- 静脉注射免疫球蛋白 (IVIG) 和葡萄糖皮质体的联合治疗显示,对于MIS-C,治疗失败率低于单独IVIG.
结论:
- 该综述综合了有关MIS-C患者特征和结果的当前知识.
- 使用IVIG和葡萄糖皮质激素的联合治疗似乎比单独使用IVIG更有效.
- 需要进一步研究手术安全性,风险因素,治疗优化以及MIS-C的长期结果.
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