手术年龄对患有上大动脉狭窄症的儿科患者的预后影响
Lizhi Lv1,2, Yuekun Sun1, Simeng Zhang3
1Department of Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
Reviews in cardiovascular medicine
|November 1, 2024
概括
在2岁以下的儿童中,手术修复无症状的上大动脉狭窄 (SVAS) 与风险增加有关. 将手术推迟到2岁以后,并及时进行,可以改善儿科SVAS患者的结果.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 上大动脉狭窄 (SVAS) 是一种影响大动脉的先天性心脏缺陷.
- 在无症状儿科SVAS患者中进行手术的最佳年龄尚不清楚.
- 这项研究调查了手术时间对无症状SVAS的结果的影响.
研究的目的:
- 评估不同年龄段的手术安全性和有效性,以管理无症状的先天性上动脉狭窄症 (SVAS).
主要方法:
- 对248名18年以上无症状儿科SVAS患者的回顾性分析.
- 患者被分为三个年龄组:<2.0岁,2.0-5.0岁和>5.0岁.
- 主要终点包括住院死亡/ECMO和重新手术/静脉缩;用于分析的Cox回归.
主要成果:
- 年龄小于2岁的患者与老年人群相比,在医院死亡或ECMO (8.3%) 的比率显著更高 (p=0.001).
- 在<2岁和>5岁的年龄组中,与2.0-5.0岁的年龄组相比,再次手术或缩的风险增加.
- 随访时间中位数为25.5个月.
结论:
- 在没有其他心脏异常的无症状儿科SVAS中,推延迟手术干预至2岁以后.
- 一旦达到最佳窗口,建议立即进行手术修复.
- 对于患有严重SVAS症状的儿童,无论年龄如何,立即进行手术至关重要.
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