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死性肠球炎 - 相关的急性损伤 - 改变范式
Padma P Garg1, Jeffrey Shenberger2, Andrew M South3,4
1Department of Pediatrics Critical Care, University of Mississippi Medical Center, Jackson, Mississippi.
American journal of perinatology
|May 20, 2024
概括
严重的急性损伤 (AKI) 在新生儿患有死角性肠球炎 (NEC) 时很常见,特别是在手术后,并且与更糟糕的结果有关. 需要更多的研究来预防这些婴儿的AKI.
科学领域:
- 新生儿医学 新生儿医学
- 儿科手术 儿科手术
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 结核性肠球炎 (NEC) 是新生儿的关键外科病症,通常导致多器官功能障碍.
- 手术NEC后的急性损伤 (AKI) 是不良临床结果和死亡率增加的重要预测因素.
- 出生时体重非常低的婴儿特别容易受到NEC的感染,影响该人口的6-10%.
研究的目的:
- 审查与NEC相关的AKI对患者结局的临床影响.
- 突出了新生儿患有NEC时需要脏保护策略的需要.
- 强调监测短期 (AKI) 和长期 (CKD) 结局的重要性.
主要方法:
- 对与NEC相关的AKI现有证据的系统审查.
- 对早产婴儿患有NEC和AKI的临床结果的分析.
- 识别有关脏保护干预措施的知识差距.
主要成果:
- 严重的AKI (2-3阶段) 影响32.6%的新生儿有NEC和58.7%手术后的NEC.
- 与NEC相关的AKI与严重的术后并发症,支气管肺功能障碍,脑损伤和长时间住院相关.
- AKI的严重程度可以作为预后指标,用于预先患有NEC的早产婴儿的临床结果.
结论:
- 严重的AKI是手术NEC的常见和严重并发症,显著恶化患者的预后.
- 需要进行评估脏保护策略的研究,以减轻AKI并改善新生儿NEC的结果.
- 未来的研究应该专注于对患有NEC的早产婴儿进行综合性结局评估,包括慢性病.
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