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患有先天性直肠形患者的功能性结果:从APSA结果和基于证据的实践委员会的系统审查和基于证据的指导方针
Kristy L Rialon1, Caitlin Smith2, Rebecca M Rentea3
1Division of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
直肠形 (ARM) 的功能结果是复杂的. 本次审查强调,虽然禁欲和生活质量可以改善,但长期泌尿道,性和心理社会问题仍然存在,需要结构化过渡护理.
科学领域:
- 儿科手术 儿科手术
- 发展生物学 发展生物学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 直肠形 (ARM) 呈现异质的功能结果.
- 患者咨询需要全面了解短期和长期后果.
- 现有的文献缺乏关于最佳功能结果评估的共识.
研究的目的:
- 系统地审查和总结有关ARM儿童功能结果的当前文献.
- 确定证据缺口,并为ARM患者护理提供最佳实践信息.
- 为制定共识指南提供基础.
主要方法:
- 对1985-2021年期间的文章进行系统的文献综述.
- 由美国儿科外科协会成果和基于证据的实践委员会起草的基于共识的问题.
- 包括109项基于C-D证据水平的研究.
主要成果:
- 在患有围和直肠静脉囊的患者中观察到更高的禁欲和便秘率,随着时间的推移,情况有所改善.
- 泌尿器官异常常见,需要进一步定义监测协议.
- 通过尽量减少胃肠道症状,可以实现良好的生活质量,尽管性和心理社会问题很常见,并且可以持续到成年.
结论:
- 对于ARM护理的最佳实践,存在显著的证据差距.
- 管理和预测的多机构注册正在出现.
- 展望性,比较性研究对于改善护理和为这种复杂的人群建立共识指南至关重要.
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