死亡性肠球炎和先天性心脏病:管理和预后的差异
R Mena Marcos1, G Guillén Burrieza1, A Castrillo Arias1
1Pediatric Surgery Department. Vall d'Hebron Barcelona Hospital Campus. Children's Hospital. Barcelona (Spain).
概括
先天性心脏病 (CC) 通过在诊断时增加血液动力学不稳定性来复杂化死角肠炎 (NEC). 虽然CC患者的NEC总体预后较差,住院时间较长,但手术需求和肠道结果与非CC病例相似.
科学领域:
- 新生儿医学 新生儿医学
- 儿科手术 儿科手术
- 心脏病学 心脏病学
背景情况:
- 死性肠球炎 (NEC) 是新生儿死亡的主要原因.
- 过早生育和缺血-再输液损伤是NEC发展的关键因素.
- 先天性心脏病 (CC) 是一个独特的情景,有助于NEC.
研究的目的:
- 研究先天性心脏病 (CC) 对新生儿死性肠球炎 (NEC) 的胃肠道和整体预后的影响.
主要方法:
- 对2015-2023年NEC案件的回顾性审查,将其分为CC和非CC组.
- 排除患有焦点肠道穿孔的患者.
- 两组之间的NEC发病,管理,手术细节,肠道干预和短期结果的比较.
主要成果:
- 在CC和非CC组之间,体重,诊断时的年龄或NEC阶段没有显著差异.
- CC患者表现出更高的血液动力学休克率,并在NEC发病时需要血管活性支持.
- 尽管手术干预需要和肠道结果相似,但CC与更长的住院时间和增加的死亡率有关.
结论:
- 患有CC的新生儿的NEC在发病时具有更大的血液动力学不稳定性.
- 先天性心脏病与NEC的总体预后更差有关,可能是由于潜在的心血管损害.
- 尽管预后较差,但手术的需要,肠部受影响和短期结果在CC和非CCNEC病例之间是可比的.
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