在接受息治疗的重病儿童中绘制外科干预轨迹
Danielle I Ellis1, Li Chen2, Samara Gordon Wexler3
1Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA; Division of Psychosocial Oncology and Palliative Care, Boston Children's Hospital/Dana Farber Cancer Institute, Harvard Medical School, Boston MA, USA.
Journal of pediatric surgery
|September 27, 2024
概括
接受息治疗 (PPC) 的重病儿童经常接受手术干预,根据疾病类型而异. 那些患有急性疾病的人早就接受高风险手术,而慢性疾病需要随着时间推移进行更多的干预.
科学领域:
- 儿科手术 儿科手术
- 抚慰性护理是一种缓解性护理.
- 复杂的慢性病 复杂的慢性病
背景情况:
- 手术干预在重病儿童中很常见,但基于特定严重疾病的使用数据有限.
- 了解手术模式对于优化患有复杂慢性疾病 (CCC) 的儿科患者的护理至关重要.
研究的目的:
- 评估从诊断到现在接受息治疗 (PPC) 的重病儿童的手术干预.
- 确定参与这些手术的外科专家类型.
主要方法:
- 从多中心前性队列研究中对197名儿童进行回顾性队列分析 (儿科息护理研究网络SHARE研究).
- 通过临床记录审查识别和抽象了手术干预.
主要成果:
- 96%的患者 (189/197) 平均5.3个CCC接受了21个专家团队的3331次手术干预.
- 血液恶性瘤,呼吸道,遗传/代谢和GI/GU诊断是最常见的.
- 患有心血管疾病,恶性瘤和早产的儿童从诊断到干预和PPC启动的间隔较短.
结论:
- 几乎所有患有PPC的重病儿童都接受了手术干预,通常是多次,跨越各种子专业.
- 根据严重疾病类型,手术干预模式有很大差异.
- 严重危及生命的疾病需要大量,高风险的早期干预措施,而慢性疾病需要更多,低风险的干预措施.
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