STAT试验:用于死性肠球炎的口腔或肠道解剖:多中心随机对照试验
Simon Eaton1, Niloofar Ganji2, Mandela Thyoka3
1UCL Great Ormond Street Institute of Child Health, London, UK. s.eaton@ucl.ac.uk.
Pediatric surgery international
|October 29, 2024
概括
对于需要手术的死性肠球炎 (NEC) 的新生儿,初级解剖导致更快的恢复和比静脉形成更少的并发症,而不会增加不良后果.
科学领域:
- 新生儿手术 新生儿手术
- 儿科外科手术 儿科外科手术
- 胃肠病学 胃肠病学
背景情况:
- 死性肠球炎 (NEC) 是新生儿严重的胃肠道紧急情况.
- 对NEC的手术治疗通常涉及肠切除.
- 在口腔形成 (ST) 和初级解剖 (PA) 之间做出选择是一个关键的外科决定.
研究的目的:
- 为了比较新生儿初级解剖 (PA) 与静脉形成 (ST) 的有效性,新生儿需要肠切除.
- 确定最佳的外科手术方法以改善患者的治疗结果.
主要方法:
- 多中心随机对照试验 (STAT试验) 涉及12个国际中心.
- 接受NEC初级腹腔切除术的婴儿在手术内随机分为PA或ST.
- 主要结局:使用考克斯回归分析的亲肠道营养 (PN) 持续时间.
主要成果:
- 在2010年至2019年期间,招募了80名患者.
- 接受PA的婴儿与ST的婴儿相比,PN的持续时间明显较短 (HR2.38,p=0.004).
- 在PA和ST组之间没有观察到死亡率的显著差异. 然而,ST组的肠道并发症较多 (p=0.02).
结论:
- 在没有远端疾病的情况下,建议对NEC进行初级解剖.
- 增强了NEC的恢复,并降低了多种肠道并发症的风险.
- 与ST相比,PA不会增加不良结果.
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