手术性死性肠球炎和自发性肠孔隙导致婴儿严重发育不良
Allison L Speer1, Kevin P Lally1, Claudia Pedroza2
1Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX.
发育不良常见于患有死性肠球炎 (NEC) 或自发性肠孔 (SIP) 的婴儿,持续长达22个月. 这项研究强调了对婴儿成长结果的重大影响.
科学领域:
- 儿科手术 儿科手术
- 新生儿科学 新生儿科学
- 增长和发展 增长和发展
背景情况:
- 手术性死性肠球炎 (NEC) 和自发性肠孔 (SIP) 的婴儿面临高死亡率和显著的神经发育和生长障碍.
- 关于这些易受伤害的婴儿长期成长结果的数据有限.
研究的目的:
- 为了确定为NEC或SIP治疗的婴儿中生长衰竭的发生率.
- 调查最初的外科手术方法 (拉巴切除术与腹膜疏通) 是否会影响生长失败的可能性.
主要方法:
- 进行了Necrotizing Enterocolitis Surgery Trial数据集的第二次分析.
- 发育不良,定义为体重Z分数<-2.0,在出院18至22个月后进行评估.
- 后勤回归模型被用来分析诊断和治疗对生长失败的影响.
主要成果:
- 在有结果数据的207名幸存者中,48%的NEC婴儿和42%的SIP婴儿在18-22个月时经历了生长失败.
- 虽然整体上没有统计学意义 (P=0.4),但SIP的婴儿显示出预测较低的平均体重-年龄Z-score (Beta -0.27;P=0.041).
- 从出生开始,体重对年龄的Z-score中位数下降在NEC婴儿中最严重.
结论:
- 发育不良是手术NEC或SIP的婴儿中普遍存在和持续存在的问题,在18-22个月内明显.
- 患有NEC的婴儿似乎特别容易发生严重的生长缺陷.
- 这项研究强调了长期监测这些疾病中幸存者的生长的必要性.
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