在新生儿肺膜中,围排水道是否仍有作用? 一个单一中心体验
Kathryn M Maselli1, Nikhil R Shah1, Sharmi C Amin1
1Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, C.S. Mott Children's Hospital, Ann Arbor, Michigan.
The Journal of surgical research
|August 23, 2024
概括
腹膜疏通 (PD) 是早产新生儿肺膜的可行的初始治疗方法,超过一半的患者表现出临床改善. 排水后的仔细评估对于非常低出生体重婴儿的持续积极结果至关重要.
科学领域:
- 新生儿手术 新生儿手术
- 儿科重症监护 儿科重症监护
- 胃肠道手术 胃肠道手术
背景情况:
- 新生儿的肺,通常是死角性肠球炎或自发性肠道穿孔引起的,是外科紧急情况.
- 对于这些新生儿的初始腹膜疏通 (PD) 的风险分层目前缺乏.
- 这项研究解决了需要更好地了解PD有效性在出生时体重非常低的婴儿.
研究的目的:
- 评估初始腹膜疏通 (PD) 的有效性,作为非常低出生体重新生儿肺腹膜的管理策略.
- 确定与成功结局相关的因素与需要进一步手术干预的因素.
- 评估PD对死亡率和住院时间的影响.
主要方法:
- 以后回顾,对出生时体重非常低的新生儿 (<1500克) 进行了肺皮的PD.
- 被定义为"响应者" (经过PD管理) 和"不响应者" (需要腹腔切除术或死亡) 的队列.
- 使用统计测试 (t 测试,奇平方,克鲁斯卡尔-瓦利斯) 进行产前/产后特征和临床数据的比较.
主要成果:
- 在56名新生儿中,55%是排水响应者,45%是无响应者.
- 不响应者表现出更高的排水后基数赤字和FiO2需求.
- 排水应答者住院时间显著缩短,死亡率较低 (6.4%与56%相比).
结论:
- 腹膜疏通是早产新生儿 (<1500克) 肺腹膜的可行的初始治疗方法,超过一半的新生儿有积极反应.
- 在研究的新生儿中,超过50%的新生儿观察到对PD的临床反应.
- 在PD后进行持续的临床评估对于确保患者持续改善和指导进一步管理至关重要.
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