在新生儿期之外的儿科胃口腔穿孔的临床过程和管理
Naohiro Takamoto1, Takaaki Konishi2, Michimasa Fujiogi3
1Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan.
Pediatrics and neonatology
|December 21, 2024
概括
患有胃口腔穿孔的幼儿 (<7岁) 面临更高的风险. 他们更有可能需要手术,密集支持,并经历更糟糕的结果,包括增加死亡率和发病率.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 儿科胃口腔穿孔的治疗方法和结果没有得到充分的记录.
- 这项研究解决了关于儿科胃肠穿孔的有限数据.
研究的目的:
- 为了比较7岁以下的儿科患者和7岁及以上的儿科患者的胃肠穿孔的特征,治疗方法和结果.
- 为了识别儿科胃口孔的风险因素和治疗差异.
主要方法:
- 从2010年7月到2021年3月,对515名儿童患者 (28天至17岁) 进行回顾性分析,这些患者因胃口腔穿孔而住院.
- 两个年龄组之间的患者人口统计,并发症,治疗方式 (手术和支持) 和结果的比较:<7岁 (n=38) 和≥7岁 (n=477).
主要成果:
- 7岁以下的儿童更有可能是女性,患有并发症,并出现胃穿孔.
- 年龄较小的儿童 (<7岁) 接受手术治疗的频率更高 (79%对55%),包括开放式手术 (58%对19%).
- 在7岁以下的儿童中,支持性护理 (机械通风,扩散性血管内凝血治疗, катехоламин,输血),重症监护病房入院,住院死亡率 (5.3%对0.4%) 和发病率 (18%对4.8%) 显著上升.
结论:
- 7岁以下儿童的儿科胃肠穿孔与更高的并发病发病率有关.
- 较小的儿童 (<7岁) 更有可能接受激烈的手术和支持性治疗.
- 与较年长的儿童相比,7岁以下的胃腹孔穿孔的儿童表现较差,包括死亡率和发病率增加.
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