周产期气道管理下异常:全国住院患者队列分析
Michael D Puricelli1, Samantha J Barr1, Johanna L Ellefson1
1University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
The Laryngoscope
|August 14, 2024
概括
异常 (MAs) 影响每10万分之119的出生,增加了对呼吸道干预的需要和并发症的风险. 目前的呼吸道管理策略不足以防止患有MAS的婴儿出现不良结果.
科学领域:
- 儿科手术 儿科手术
- 新生儿科学 新生儿科学
- 头骨面部异常 头骨面部异常
背景情况:
- 异常 (MAs) 涵盖了一系列影响发育的疾病.
- 这些异常会显著影响通气道的通透性,需要专门的医疗护理.
- 了解与MAs相关的发生率和结果对于改善患者护理至关重要.
研究的目的:
- 为了确定各种下异常 (MA) 现象型的发生率.
- 为了比较妊娠年龄,呼吸道干预和不同MA表型的婴儿与未受影响的婴儿的并发症.
- 评估MA患者当前呼吸道管理的有效性.
主要方法:
- 使用了医疗保健成本和利用项目儿童住院患者数据库 (2000-2020).
- 分类的气道干预作为围产期 (生命的一天0-1) 或之后.
- 定义了缺氧并发症,并使用描述性统计数据和罗-斯科特奇平方测试对照组.
主要成果:
- 在每10万例分娩访问中,MAs发生在119例中,在所有表型中,早产的频率更高.
- 患有MAs的婴儿需要医疗护理的比例明显更高 (16.2%-70.7%与3.8%相比).
- 尽管早期气道干预的比率较高,但MA患者的缺氧并发症或死亡风险略高 (32.4%与26.4%相比).
结论:
- 过早分娩在MAs中很常见,但并不能完全解释增加对呼吸道干预的需求.
- 患有MAS的个体需要更多的医疗照顾,这突出了当前护理的差距.
- 现有的气道管理协议不足以预防患有MAS的婴儿的并发症和死亡率.
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