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在婴儿和儿童中使用胃结节管的并发症率和变异性
Oliver S Zhao1, Maren E Shipe2, Melissa E Danko3
1Vanderbilt University School of Medicine, Nashville, TN, USA.
Journal of pediatric surgery
|November 16, 2024
概括
胃结节管 (GJT) 放置并发症的发生率在婴儿和老年儿童中相似. 非洲裔美国儿童和那些接受紧急手术的人患上并发症的风险更高,这表明年龄不是GJT安置的禁忌.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 胃结合管 (Gastrojejunostomy tubes,GJT) 对于有食不耐症的儿童进入肠道至关重要.
- 之前的研究表明,与老年儿童相比,接受GJT安置的婴儿的并发症风险更高.
- 这项研究使用国家数据库调查了儿童的GJT使用和相关的术后并发症.
研究的目的:
- 描述小儿病患者使用胃口结节管 (GJT) 的情况.
- 为了确定儿童在GJT安置后出现术后并发症的危险因素.
- 为了比较接受GJT安置的婴儿和非婴儿之间的并发症率.
主要方法:
- 这是一项回顾性队列研究,利用美国小儿外科医生学院国家外科质量改善计划 (Ped-NSQIP) 和小儿健康信息系统 (PHIS) 数据库.
- 在每个数据库中,婴儿 (<1岁) 和非婴儿 (≥1岁) 之间的并发症率的比较.
- 多变量后勤回归分析,以确定术后并发症的预测因素.
主要成果:
- 在任何一个数据库中,婴儿与非婴儿相比,手术并发症的发生率都没有增加 (Ped-NSQIP:26.9% vs. 29.0%;PHIS:35.3% vs. 30.7%).
- 在非洲裔美国儿童 (婴儿和非婴儿) 和在两个年龄组的紧急/紧急手术中观察到并发症风险增加.
- 在GJT安置和并发症率方面,有显著的机构差异.
结论:
- 胃结节管 (GJT) 放置的整体并发症率很大,但在婴儿和非婴儿之间是相似的.
- 术后并发症的风险与种族和程序的紧迫性有关,而不仅仅是年龄.
- 应该考虑将GJT放置在儿童的肠道上,无论年龄如何.
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