手术干预的时间是否会影响死性肠球炎的结果?
Jessica L Rauh1, Menaka N Reddy1, Nicole L Santella1
1Wake Forest School of Medicine, General Surgery, Winston Salem, NC, USA.
The American surgeon
|May 25, 2024
概括
婴儿死性肠球炎 (NEC) 的早期手术干预与更高的死亡率和更多的肠切除有关. 延迟干预可能会改善结果,因此需要进一步研究手术NEC (sNEC) 的最佳时间.
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
- 关键护理医学 关键护理医学
背景情况:
- 关于手术性死性肠球炎 (sNEC) 管理时间进行了讨论.
- 目前的外科手术方法包括腹疏通 (PD),腹腔切除 (LAP) 和联合PD + LAP.
- 延迟干预对医疗优化的潜在益处尚未被探索.
研究的目的:
- 评估早期 (<48小时) 与晚期 (>48小时) 手术干预对患有sNEC的婴儿结局的影响.
- 为了确定延迟的外科干预是否允许更好的患者复苏和改善的结果.
主要方法:
- 从2012年至2022年间,对118名患有sNEC的婴儿的临床数据进行了回顾性分析.
- 婴儿接受早期 (<48小时) 和晚期 (>48小时) 手术干预之间的结局的比较.
- 分析包括死亡率,肠切除长度和MD7标准得分.
主要成果:
- 接受早期干预的婴儿被诊断为更年轻的婴儿,并呈现出更多的肺.
- 早期干预组的死亡率明显较高 (35%vs.15%),肠切除幅度更大 (29厘米vs.9厘米).
- 即使不包括患有肺关节炎的婴儿,早期干预也与更高的死亡率和更广泛的肠切除有关.
结论:
- 在sNEC的早期手术干预与增加的死亡率和发病率有关,包括大肠切除.
- 该研究强调了对干预时间的非特定48小时截止时间的限制.
- 研究结果表明,在手术前进行一段医疗优化可能会改善sNEC的结果,因此需要进一步调查.
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