评分系统来评估非手术管理失败的风险,在孩子们的内分泌
Michela Carter1, Jonathan Afowork1, J Benjamin Pitt1
1Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
The Journal of surgical research
|June 14, 2024
概括
一个新的评分系统准确地预测了在阴囊减少失败后,有肠塞的儿童何时需要手术. 这种工具有助于识别高风险病例,以更好地管理儿科患者的肠接.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 手术干预 手术干预
- 医学诊断 医学诊断 医学诊断
背景情况:
- 对于儿童来说,肠接治疗通常是从减少阴囊开始的.
- 如果非手术治疗失败,就需要进行外科手术.
- 非手术治疗失败的预测因素在临床实践中并不一致应用.
研究的目的:
- 开发一个预测性评分系统,用于在儿科内中非手术性管理失败.
- 识别患有需要手术干预的高风险儿童.
主要方法:
- 对143例儿科内肠胎病例 (2019-2022) 的回顾性审查.
- 后勤回归分析,以确定非操作性故障的预测因素.
- 基于重要预测因素的风险评分系统的开发.
主要成果:
- 19.6%的病例需要操作干预.
- 衰竭的关键预测因素包括年龄≥4岁,≥1次阴囊尝试失败,心率≥128,缩血压≥115 mmHg和超声波上被困的液体.
- 开发的评分系统显示了高分辨能力 (AUC 0.96),基于分数的不同失败风险 (低≤2,中等3-4,高≥5).
结论:
- 一个新的风险评分系统有效地预测了儿科内肠置的外科干预需求.
- 该系统利用已确定的风险因素,并显示出出色的预测能力.
- 在临床实施之前建议进行前性验证.
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