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产前与产后手术治疗骨髓髓瘤结核的结果:系统性审查和元分析

João Pedro Veras Torres¹, Helvécio Neves Feitosa Filho², Rian Vilar Lima²

¹School of Medicine, Universidade de Fortaleza, Av. Washington SoaresEdson Queiroz, CEP 60.811-905, Fortaleza, CE, 1321, Brazil. jpverastorres.med@gmail.com.

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

|December 15, 2025

概括

胎儿骨髓髓瘤手术减少了对心室外皮质变流 (VPS) 的需要,并改善了运动功能. 然而,与产后修复相比,它与增加的孕产妇风险有关.

科学领域:

胎儿医学胎儿医学
儿科外科手术儿科外科手术
神经科学是一个神经科学.

背景情况:

骨髓髓瘤结核是一种严重的出生缺陷,具有显著的长期影响.
手术修复是适用的,包括胎儿 (在子宫内) 和产后干预的选择.
与每个方法相关的结果和风险需要仔细比较.

研究的目的:

系统地比较胎儿与产后骨髓瘤手术的临床和功能结果.
为了评估新生儿和孕产妇的并发症,需要进行心室-腹腔周围切换 (VPS),以及长期的运动结果.

主要方法:

一个系统的审查和元分析,遵循PRISMA指南.
在Medline,Embase,Web of Science和Cochrane Central进行的搜索截至2024年12月.
随机效应模型用于分析11项研究的数据 (751例胎儿,1169例产后修复).

主要成果:

胎儿手术显著降低了对VPS的需求 (OR 0.08),并改善了独立行走 (OR 3.89).
与胎儿修复 (OR 0.15) 观察到的后脑发生率降低.
胎儿手术与较高的孕产妇风险相关,包括小水 (OR 4.60);围产死亡率没有差异.

结论:

胎儿骨髓瘤手术在减少水头和提高运动结果方面具有显著的好处.
改善的胎儿结果必须与增加的孕产妇并发症率相对衡量.
进一步的研究可能会完善患者选择和手术技术.

关键词:

胎儿外科手术胎儿外科手术骨髓灰质炎是一个巨大的疾病.产后手术产后手术在产前手术中进行产前手术.

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