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中国非常早产婴儿的自发肠道穿孔:一个多中心队列研究
Weiying Mao1, Siyuan Jiang1, Chun Shen2
1Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Translational pediatrics
|May 8, 2024
概括
自发性肠穿孔 (SIP) 影响了中国大约1%的非常早产婴儿,显著增加了他们死亡和严重健康问题的风险. 超过90%的这些婴儿需要腹腔切割进行手术治疗,突出显示了需要更好的预防和管理策略.
科学领域:
- 新生儿手术 新生儿手术
- 儿科胃肠病学 儿科胃肠病学
- 新生儿学中的公共卫生.
背景情况:
- 自发性肠穿孔 (SIP) 是早产婴儿的一种关键的手术条件.
- 关于中国非常早产婴儿 (<32周妊娠年龄) 的SIP患病率,死亡率和发病率的数据有限.
研究的目的:
- 确定中国非常早产婴儿中SIP的患病率,治疗和结果.
- 分析SIP与新生儿结局之间的关联.
主要方法:
- 从2019年1月到2020年12月,对出生在24+0-31+6周妊娠年龄之间的婴儿进行了回顾性队列研究.
- 纳入标准:在中国新生儿网络中,新生儿在出生后七天内进入新生儿重症监护室的婴儿.
- 评估结果:没有重大发病的生存率,死亡率,晚发性败血症和使用多变量逻辑回归的支气管肺功能障碍.
主要成果:
- 1.0% (150/15,814) 的非常早产婴儿患有SIP,在最早的怀孕中发病率最高 (2.4%在24~25+6周).
- SIP与没有重大疾病的生存率显著降低 (29.3%对59.2%) 和死亡风险增加 (aOR 3.36),晚发性败血症 (aOR 2.10) 和支气管肺功能失调 (aOR 2.49) 相关.
- 手术干预,主要是腹腔切除 (92.6%),是常见的,尽管18.7%没有接受手术治疗.
结论:
- 在中国,SIP影响了大约1%的非常早产婴儿,对死亡率和发病率有很大的风险.
- 大多数SIP病例需要手术干预,主要是腹腔切除术.
- 迫切需要基于证据的战略来预防和管理这种脆弱人群中的SIP.
相关概念视频
01:22Esophageal Perforation-I: Introduction
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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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01:28Esophageal Perforation-II: Clinical Manifestations and Management
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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
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