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患有神经母细胞瘤的儿童手术后流的危险因素和预测值:一项回顾性队列研究
Jing Hu1, Ping Chu2, Jun Feng3
1Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
World journal of surgical oncology
|July 16, 2025
概括
鉴定神经母细胞瘤切除后术后外流的危险因素至关重要. 长时间的手术时间,低白蛋白和高C反应蛋白是儿童患者干预的关键指标.
科学领域:
- 儿科手术 儿科手术
- 在瘤学瘤学.
- 关键护理医学 关键护理医学
背景情况:
- 手术后的流是儿童神经母细胞瘤切除后的常见并发症.
- 对于这种并发症,存在有限的基于证据的风险分层.
- 这项研究旨在确定独立的风险因素,并确定外科手术期间风险减轻的门.
研究的目的:
- 在儿科神经母细胞瘤患者中确定术后外流的独立危险因素.
- 建立临床可行的临床值,以缓解外科手术期间的风险.
- 通过启用有针对性的干预措施来改善患者的治疗结果.
主要方法:
- 对165名经过腹部神经母细胞瘤切除的儿科患者 (2018-2020年) 的回顾性分析.
- 收集了从手术前期到手术后3年的82个变量.
- 多变量物流回归和ROC曲线分析以确定风险因素和值.
主要成果:
- 需要干预的术后流发生在21.82%的患者中.
- 确定的主要危险因素包括:低BMI Z-score,上腺瘤起源,低手术前血红蛋白,延长的手术时间,低术后第1天的白蛋白和高术后第1天的C-反应蛋白.
- 对于这些风险因素,建立了临床可操作的值.
结论:
- 长时间的手术时间可能意味着系统性炎症的增加.
- 术前炎症调节,适当的白蛋白水平和优化术前营养是降低风险的潜在目标.
- 这些发现是初步的,需要在更大的前性研究中得到验证.
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