诺伍德程序的标准化改善了中型体积中心的结果
W Hampton Gray1, Robert A Sorabella1, Ashely B Moellinger2
1Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
World journal for pediatric & congenital heart surgery
|June 10, 2024
概括
为低可塑性左心结构标准化诺伍德手术改善了患者的治疗结果. 这种方法减少了输出管的时间,内的持续时间和住院时间,提高了对高风险新生儿的护理.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 新生儿心脏病学 新生儿心脏病学
- 遗传性心脏病管理与管理
背景情况:
- 诺伍德手术是对低可塑性左心结构的关键息手术.
- 尽管取得了进展,但在II期息治疗之前,患者的流失仍然很大.
- 优化接受诺伍德手术的新生儿的治疗结果仍然是优先事项.
研究的目的:
- 评估对诺伍德行动采用标准化方法的影响.
- 为了比较在实施标准化协议之前和之后的结果.
- 为了确定患者发病率和资源利用率的改善.
主要方法:
- 对接受诺伍德手术 (不包括混合手术) 患者的回顾性分析.
- 标准化前 (2015-2020年) 和标准化后 (2020-2023年) 组的比较.
- 对关键结局的分析,包括输出管时间,内持续时间和住院时间.
主要成果:
- 标准化后与显著减少的输出输出时间 (OR 0.87) 有关.
- 在标准化后观察到降低的内持续时间 (OR 0.92) 和住院时间 (OR 0.98).
- 报告指出,心脏骤停的趋势有所下降,再干预率和间期死亡率有所下降.
结论:
- 诺伍德手术的标准化方法可以改善患有左心结构低可塑性的新生儿的结果.
- 标准化可能会导致病率降低和医院资源利用更有效.
- 建议采用机构协议,以优化对这种高风险人群的护理.
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