极低出生体重婴儿的医疗保健需求与NEC和自发性肠孔穿孔的比较
Priyanka V Chugh1, Emily Nes1, Katherine Culbreath1
1Boston Children's Hospital, Department of Surgery, Boston, MA, USA.
Journal of pediatric surgery
|April 1, 2024
概括
在极低出生体重 (ELBW) 婴儿中,死性肠球炎 (NEC) 和自发性肠孔 (SIP) 都会增加神经发育问题和医疗需求的风险. 与SIP相比,NEC具有较高的严重神经发育障碍和出院后手术风险.
科学领域:
- 新生儿科学 新生儿科学
- 儿科手术 儿科手术
- 发育儿科 发育儿科
背景情况:
- 结核性肠球炎 (NEC) 和自发性肠孔 (SIP) 影响6-8%的极低出生体重 (ELBW) 婴儿.
- 虽然SIP的死亡率低于NEC,但这两种疾病的短期发病率相似.
- 在ELBW婴儿中NEC和SIP后的长期神经发育结果仍然不清楚.
研究的目的:
- 为了比较ELBW婴儿的长期神经发育和医疗保健结果,腹腔切除术确认的NEC与SIP.
- 评估严重神经发育障碍,生长衰竭,再住院和出院后手术需要的风险.
主要方法:
- 从2011-2018年出生的59个北美新生儿单位收集ELBW婴儿 (401-1000g或22-27周妊娠年龄) 的前性数据.
- 在16-26个月的后续评估中,对确诊NEC,SIP和对照的婴儿进行了年龄校正.
- 主要结局:严重的神经发育障碍. 二次结果:体重小于百分之十,医疗再入院,出院后手术和家庭医疗支持.
主要成果:
- 在直接比较NEC和SIP时,总体结果没有统计学上显著的差异.
- 与对照组相比,患有NEC的婴儿的严重神经发育障碍 (ARR 1.43) 和再住院 (ARR 1.46) 的风险明显更高.
- 与对照组相比,患有NEC (ARR1.82) 和SIP (ARR1.64) 的婴儿都有增加的退院后手术风险.
结论:
- 患有NEC的ELBW婴儿面临严重神经发育障碍的显著增加风险和出院后更大的医疗保健需求.
- 患有SIP的ELBW婴儿也经历了医疗保健需求的增加,特别是在出院后的手术方面.
- 这些发现强调了对NEC和SIP幸存者的长期监测的重要性.
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