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出生腹膜患者患有左心缺血症和左心室功能障碍,死亡率最高

María V Fraga¹, Holly L Hedrick², Natalie E Rintoul¹

¹Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania. Philadelphia, PA.

The Journal of pediatrics

|April 18, 2024

概括

患有先天性隔膜 (CDH) 和左心室 (LV) 功能障碍和左心缺血症 (LHH) 的婴儿面临体外膜氧化 (ECMO) 和死亡的最高风险. 这凸显了早期发现和管理这些综合性疾病的必要性.

科学领域:

儿童心脏病学儿童心脏病学
新生儿手术新生儿手术
遗传性心脏病是一种先天性心脏病.

背景情况:

kongenital diaphragmatic hernia (CDH) 是一种严重的疾病,通常与心脏异常有关.
左心室 (LV) 功能障碍和左心缺血症 (LHH) 是已知的CDH患者的并发症.
了解这些心脏问题的范围和影响对于患者的治疗结果至关重要.

研究的目的:

确定患有CDH的婴儿中LV功能障碍和LHH的患病率.
调查心脏异常和CDH严重程度之间的关联.
评估 LV 功能障碍和 LHH 对体外膜氧化 (ECMO) 和死亡率的需要的影响.

主要方法:

从2017年1月到2022年5月,对182名CDH患者进行了回顾性队列研究.
用心声图来前性评估LV功能和LHH.
根据LV功能障碍和LHH的存在或不存在,患者被分为四组.

主要成果:

28%的CDH患者表现出LV功能障碍和LHH.
观察到左心病的严重程度和ECMO和死亡的几率增加之间存在剂量反应关系.
在对CDH严重程度进行调整后,患有LV功能障碍和LHH的婴儿需要ECMO (OR 1.76) 和死亡率 (OR 2.76) 的几率明显更高.

结论:

在CDH患者中,LV功能障碍和LHH的组合与ECMO使用和死亡率的最高风险有关.
这些发现强调了CDH新生儿全面心脏评估的重要性.
早期识别和管理LV功能障碍和LHH联合的策略可以提高CDH的生存率.

关键词:

生产性腹膜 Hernia 是一种先天性腹膜.左心脏的低增多症.左心室功能障碍是什么肺动脉高血压肺动脉高血压

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