在Robin序列的婴儿中进行初级裂口 palatal修复后的术后呼吸困难与隔离裂口 palatal:一项回顾性研究
Shirley van de Velde1, Merel M Smit1, Robrecht J H Logjes1
1Department of Pediatric Plastic and Reconstructive Surgery, University Medical Center Utrecht, Wilhelmina Children's Hospital, Lundlaan 6, 3584 EA, Utrecht, the Netherlands.
概括
罗宾序列 (RS) 的婴儿,特别是非隔离的RS,在口腔裂口修复 (CPR) 后面临更高的术后呼吸困难 (PRD) 风险. 手术前的 palatal plate 分析显示,这些婴儿的 PRD 预测值有限.
科学领域:
- 儿科手术 儿科手术
- 头骨面部异常 头骨面部异常
- 呼吸系统医学 呼吸系统医学
背景情况:
- 裂口 palatal修复 (CPR) 是一个常见的婴儿手术程序.
- 手术后呼吸困难 (PRD) 是一个已知的并发症.
- 罗宾序列 (RS) 由于呼吸道解剖学而存在独特的挑战.
研究的目的:
- 在初级心肺复苏后,将PRD发病率与隔离的口腔裂 (iCP) 和罗宾序列 (RS) 婴儿进行比较.
- 评估RS婴儿手术前 palatal plate 分析的实用性.
- 在接受心肺复苏的婴儿中确定PRD的风险因素.
主要方法:
- 从2009年1月到2022年6月接受初级心肺复苏的婴儿的回顾性审查.
- 包括患有iCP和RS的婴儿 (进一步分为非隔离RS[niRS]和隔离RS[iRS]).
- 统计分析以比较PRD的发病率,并评估口腔板查的影响.
主要成果:
- 与ICP婴儿相比,RS婴儿的PRD发病率显著更高 (14/53与9/74相比,p=0.04).
- 患有niRS的婴儿与iCP婴儿相比,PRD的风险明显更高 (OR=4.16,p=0.031).
- 在RS婴儿 (n=25) 进行手术前口腔板查时,没有发现异常,也没有改变手术后的管理,也没有预测PRD.
结论:
- 患有niRS的婴儿在初级心肺复苏后比iRS或iCP婴儿更容易患上PRD.
- 在RS婴儿中推迟心肺复苏以避免PRD没有明显的益处.
- 在手术前进行的 palatal plate 分析对于识别RS婴儿有PRD风险的预测价值很低.
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