在早产婴儿中实施早期干预策略,治疗出血后心室扩张
Diane Wilson1, Sara Breitbart2, Lee DiFonzo3
1Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. diane.wilson@sickkids.ca.
概括
在早产婴儿的后出血性心室扩张 (PHVD) 早期干预是可行的. 与延迟治疗相比,这种方法改善了神经发育结果,在32周或之前出生的婴儿提供了更好的结果.
科学领域:
- 新生儿神经病学 新生儿神经病学
- 儿科神经外科 儿科神经外科
- 发育儿科 发育儿科
背景情况:
- 流血后心室扩张 (PHVD) 是早产婴儿的一种严重并发症.
- 对于PHVD干预的最佳时机仍在争论中.
- 目前的管理策略各不相同,影响婴儿的结果.
研究的目的:
- 评估早期干预对PHVD早产婴儿短期和长期结果的影响.
- 为了比较早期和晚期干预组之间的神经发育结果.
- 评估启动早期PHVD管理的可行性.
主要方法:
- 追溯性,多中心,观察性研究.
- 包括早产婴儿 (≤32周怀孕) 患有PHVD.
- 分析的干预策略:腰部穿刺 (LP),心室接入装置 (VAD) 和变位.
主要成果:
- 在70名幸存者中,46%的人有自发的PHVD解决.
- 38名婴儿需要使用LP,VAD或车进行干预.
- 早期干预,开始在较小的心室大小,显示了婴幼儿发育贝利尺度 (BSID-III) 的得分与历史晚期干预队列相比有所改善.
结论:
- 对早产婴儿PHVD的早期干预是可行的.
- 早些时候开始干预与改善神经发育结果有关.
- 这种方法比延迟治疗策略提供了潜在的优势.
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