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与美相关的阻塞和临床结果在期限和早产婴儿

Jordan M Rook^1,2, Nikhil Chervu^1,3, Kara L Calkins⁴

¹Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California.

JAMA network open

|February 14, 2025

概括

与美相关的阻塞 (MRO) 最常见的是影响没有囊性纤维化或赫施普朗格病的早产婴儿. 这些婴儿经历了更多的手术率,更长的住院时间和更高的成本,突出了针对性干预的需要.

科学领域:

新生儿科学新生儿科学
儿科手术儿科手术
胃肠病学胃肠病学

背景情况:

教科书估计表明,囊性纤维化和赫施普隆病导致大多数与相关的阻塞 (MRO).
发生率和MRO的结果,特别是早产婴儿与不成熟的肠道,并没有很好地建立.
目前的理解可能无法准确地反映MRO在不同婴儿群体中的病因和影响.

研究的目的:

通过特定原因确定活产婴儿中MRO的发病率.
评估MRO与关键临床结果之间的关联,包括死亡率,手术,住院时间和成本.
调查早产婴儿中MRO的特定风险和结果.

主要方法:

从2016年至2020年使用国家住院患者样本 (NIS) 进行回顾性队列研究.
使用调查权重方法,根据病因学估计了国家MRO发病率.
多变量回归模型分析了与MRO相关的因素及其对临床结果的影响,并对共变量进行调整.

主要成果:

在3,550,796名婴儿中,1844名 (0.1%) 接受了MRO治疗.
囊性纤维化和赫施普朗格病分别仅占MRO病例的2.2%和3.3%;94.5%的人没有任何条件.
没有CF或希希斯普朗格疾病的早产婴儿的MRO发病率最高 (每10万分生187.3),并且经历了增加的手术,更长的住院时间和更高的成本,但死亡率没有增加.

结论:

与美相关的阻塞 (MRO) 主要观察到缺乏囊性纤维化或赫施普隆病的早产婴儿.
在这一群体中,MRO与显著更高的腹部手术率,长时间住院和医疗保健成本增加有关.
这些发现强调了在未经研究的早产婴儿群体中开发MRO专业预防和治疗策略的必要性.

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