在所有直肠形症中,每年用超声波进行脏监测可能不需要
Shruthi Srinivas1, Kristina Booth2, Susan Kasubick-Tillman2
1Department of Colorectal and Pelvic Reconstruction Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Journal of pediatric surgery
|April 9, 2025
概括
对于患有轻度直肠形 (ARM) 的儿童,每年进行脏超声波 (RUS) 很少检测出无症状问题. 大多数患有正常初始RUS的儿童在修复后不需要进一步查,从而节省资源并减少患者负担.
科学领域:
- 儿科手术 儿科手术
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗成像医学成像
背景情况:
- 患有直肠形 (ARM) 的儿童面临患异常的风险更高.
- 目前的方案往往涉及每年超声波 (RUS) 对所有ARM患者,无论症状严重程度.
- 对所有ARM病例的这种积极查方法的必要性仍然不确定.
研究的目的:
- 为了评估各种类型的不太严重的ARM的儿童的结果,根据常规年度脏超声波 (RUS) 的协议进行管理.
- 确定在这个儿科群体中积极查脏的临床效用和产量.
- 评估RUS查对轻度ARM儿童脏异常的识别和管理的长期影响.
主要方法:
- 从2014年到2023年,在一个儿科结直肠中心进行了回顾性审查.
- 包括那些患有不太严重的ARM (例如,囊,狭窄,缩) 的儿童,这些儿童在初级修复后两年内接受了RUS.
- 人口统计,临床变量和RUS发现 (修复前和后) 的数据使用描述性统计数据收集和分析.
主要成果:
- 在333名符合条件的儿童中,197名在两年内患有术后RUS. 大多数 (70.1%) 显示正常的初始术后RUS结果.
- 只有4名患者 (2.0%) 的RUS发现在随后的扫描中变得异常.
- 一名无症状儿童 (0.5%) 通过RUS检测出脏异常,需要进行干预,尽管经过多次查.
结论:
- 在轻度ARM的儿童中,在初级修复后的常规年度RUS产生了需要干预的无症状脏异常的低发病率 (0.5%).
- 如果初始术后RUS在轻度ARM患者中正常,那么随后每年对无症状个体进行查不太可能是必要的.
- 这表明,在这个患者群体中,可能会向更有选择性的脏查方案转变,优化资源配置并最大限度地降低患者负担.
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