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在罗宾序列中部干扰后的并发症的累积负担
Asli Pekcan1,2, Raina K Patel2, Valeria Mejia1,2
1Division of Plastic and Reconstructive Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
概括
在罗宾序列 (RS) 患者中,伴随性疾病显著增加了下分心骨质生成 (MDO) 后的重大并发症和再入院. 精心进行手术前评估和手术后监测对于管理这些高风险儿童至关重要.
科学领域:
- 儿童手术
- 头面部手术
- 睡眠药物
背景情况:
- 在罗宾序列 (RS) 患者中,部分心骨质生成 (MDO) 是阻塞性睡眠呼吸暂停 (OSA) 的关键治疗方法.
- 在RS患者中,并存疾病 (并发症) 对MDO结果的影响尚不清楚.
- 本研究研究了伴随性疾病负担对RS中MDO后的术后并发症的影响.
研究的目的:
- 在Robin Sequence患者中评估并发症和MDO后术后并发症之间的关联.
- 识别特定的并发症, 预测主要的并发症, 再入院, 再次手术.
- 确定多种并发症对MDO结果的累积影响.
主要方法:
- 在2004年至2023年期间在高等儿童医院接受MDO的86名罗宾序列患者的回顾性队列研究.
- 收集的数据包括患者人口统计,并发症 (呼吸道,心脏,低血压,胃肠道),手术前输管状态和随访时间.
- 主要评估结果是主要并发症,再入院和重新手术,使用多变量后勤回归分析.
主要成果:
- 27. 9% 的患者出现严重并发症,12. 8% 的患者需要重新入院,而 19. 8% 的患者需要重新手术.
- 呼吸和心脏并发症是主要并发症的独立预测因素 (P < .05).
- 每个额外的并发症都增加了2. 7倍 (P = .012) 的重大并发症的几率,并增加了4. 2倍 (P = .008).
结论:
- 在RS患者中,伴随性疾病的负担显著影响了MDO后重复症,再入院和重新手术的风险.
- 术前输入管是重新接收的预测因素,强调需要仔细的呼吸管理.
- 对于接受MDO的高风险患者,加强手术前查,风险分层,患者咨询和紧密的术后跟踪是必不可少的.
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