影响新生儿死性肠球炎外科治疗的因素:系统性审查和元分析
Dandan Wang1, Fanhui Zhang1, Jiarong Pan1
1Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333#, Bin Sheng Road, Hangzhou, Zhejiang, 310052, P.R. China.
BMC pediatrics
|August 9, 2024
概括
新生儿死性肠球炎 (NEC) 通常需要手术. 手术干预的关键风险因素包括高C反应蛋白 (CRP) 水平,败血症,凝血障碍,较低的妊娠年龄,缺乏食和低血症.
科学领域:
- 新生儿医学 新生儿医学
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
背景情况:
- 死性肠球炎 (NEC) 是新生儿的关键胃肠道紧急情况.
- 治疗从医疗管理到外科干预各不相同,指导手术决策的证据有限.
- 手术结果的变化凸显了需要更好的风险分层.
研究的目的:
- 确定与新生儿NEC手术干预相关的重大风险因素.
- 帮助预测受影响的新生儿手术干预的最佳时间.
主要方法:
- 在PubMed,Embase和Web of Science数据库中进行了全面的文献搜索.
- 包括病例控制研究,重点关注需要手术的NEC风险因素.
- 数据分析使用R Studio进行,搜索于2024年6月16日完成.
主要成果:
- 分析了18项研究,包括1,104例外科手术和1,686例医疗治疗的NEC病例.
- 手术的重大风险因素包括高C反应蛋白 (CRP) 水平,败血症,凝血障碍,缺乏肠道养和低血症.
- 较低的妊娠年龄也被确定为手术干预的重要风险因素.
结论:
- 高CRP水平,凝血障碍,败血症,较低的妊娠年龄,缺少肠道养和低血是外科NEC的关键预测因素.
- 这些已识别的风险因素对改善新生儿NEC手术风险评估具有潜在的临床意义.
- 建立明确的外科治疗指示可以帮助标准化治疗,并改善新生儿NEC的结果.
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