患有严重支气管肺失育症的婴儿的尼森基层复合:与倾向匹配的分析
Raissa Li1, Nicole M Chandler2, Aaron Germain3
1Division of Pediatric Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida; Tufts University School of Medicine, Boston, Massachusetts.
The Journal of surgical research
|May 25, 2024
概括
在患有严重支气管肺功能障碍 (sBPD) 的早产婴儿中,尼森基囊复合与更长的住院时间和更多的资源使用有关. 需要进一步的研究来确定其在这个弱势群体中的益处和适应症.
科学领域:
- 新生儿医学 新生儿医学
- 儿科手术 儿科手术
- 呼吸系统医学 呼吸系统医学
背景情况:
- 支气管肺功能障碍症 (BPD) 是早产婴儿的一种严重的呼吸道并发症.
- 尼森基囊复合有时用于患有BPD的婴儿,以防止胃食道逆流引起的吸收.
- 在BPD中尼森基复制的确切指示和益处尚不清楚.
研究的目的:
- 评估尼森基囊复制与患有严重BPD (sBPD) 的婴儿的临床结果之间的关联.
- 使用倾向分数匹配来最大限度地减少分析中的偏差和混.
主要方法:
- 包括2016年1月至2021年10月期间入院的sBPD (妊娠年龄≤31周) 婴儿.
- 倾向性得分匹配 (1:2比) 用于比较接受尼森基囊切除术的婴儿与没有接受尼森基囊切除术的婴儿.
- 评估的关键结果包括无呼吸器支持的时间,NICU出院的时间和出院后1年的再入院或死亡.
主要成果:
- 在匹配后,18名尼森婴儿与30名非尼森婴儿进行了比较.
- 尼森小组显示了更长的呼吸支自由时间的趋势 (105天而不是70天).
- 尼森基囊复合与更长的初始住院时间 (188 vs. 111天),更高的一年再入院率 (83% vs. 50%) 和更高的气管切除术使用率 (28% vs. 0%) 相关.
- 一年出院后的死亡率在各组之间相似 (6%对10%).
结论:
- 在患有sBPD的婴儿中,尼森基囊复合与长时间的呼吸支持和增加医疗保健资源利用率有关.
- 这些发现表明,在没有明确的指示的情况下,在治疗sBPD时使用尼森基底复合时应谨慎使用.
- 需要进行前性研究,以确定适当的指示,并证实在这个患者群体中基复合的益处.
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