在诺伍德手术后进行例行初级关闭
Marcos F Mills1, Mohan M John2, Maureen McKiernan2
1Heart Center, Children's Healthcare of Atlanta; Division of Pediatric Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
World journal for pediatric & congenital heart surgery
|September 9, 2025
概括
诺伍德手术后的初级胸关闭 (PSC) 是安全有效的,与延迟胸关闭 (DSC) 相比,导致更好的生存率和更短的住院时间. DSC不是死亡率或感染的独立风险因素.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 遗传性心脏病是一种先天性心脏病.
- 新生儿重症监护中心
背景情况:
- 延迟关闭 (DSC) 在诺伍德手术后经常用于帮助心肌恢复.
- 这家机构主要使用初级关闭 (PSC),除非存在高风险因素.
研究的目的:
- 为了分析初级关闭 (PSC) 与延迟关闭 (DSC) 的结果,按照诺伍德程序.
- 确定DSC是否是死亡率或传染性并发症的独立风险因素.
主要方法:
- 对116名接受诺伍德手术的新生儿 (2017-2022) 的回顾性审查.
- 患者被分为PSC (n=80) 和DSC (n=36) 组.
- 基线人口统计,临床特征,术后细节,手术生存率和感染并发症的比较.
主要成果:
- 在PSC患者中,手术前的内使用率较低,绕道运行较少,机械循环支持的需求也较少.
- 在PSC组中,住院存活率更高 (91.3%对66.7%),住院时间更短 (29天对78天).
- 5.2%的PSC患者需要重新打开胸;DSC不是死亡率 (OR 1.42) 或感染 (OR 2.22) 的独立风险因素.
结论:
- 在诺伍德手术后,对大多数新生儿来说,初级胸关闭是可行的选择,与有利的结果有关.
- 延迟胸关闭可能有利于选择的高风险患者.
- 在PSC和DSC之间的选择应根据患者特定的风险因素进行个性化.
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