在患有希尔施普朗格病的儿童中提供手术前营养支持:一个前性的多中心开放标签随机对照试验
Hong-Yi Zhang1, Ke Chen1, Yanmin Zhang2
1Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, China.
手术前的营养支持显著降低了手术儿童的希尔施普朗相关肠球炎 (HAEC) 的风险. 这种干预可以在患有赫施普朗格病 (HSCR) 的儿科患者中将HAEC发生率降低20%以上.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 临床营养学 临床营养学
背景情况:
- 术前营养不良常见于儿科赫施普朗格病 (HSCR) 患者.
- 希尔施普朗相关肠球炎 (HAEC) 是一个严重的术后并发症.
- 术前营养支持在缓解HAEC中的作用需要进一步研究.
研究的目的:
- 评估手术前营养支持 (PNS) 在降低术后HAEC发生率方面的有效性.
- 为了比较接受PNS和接受标准医疗保健 (SMC) 的儿科HSCR患者之间的HAEC率.
主要方法:
- 一个前性的,多中心的,开放的随机对照试验,涉及110名小儿HSCR患者进行拉透手术.
- 患者被随机分配1:1到PNS (n=55) 或SMC (n=55).
- 主要结局是术后3个月的HAEC发病率.
主要成果:
- 在PNS组中,HAEC的发病率明显低于SMC组 (29.09%) 的PNS组 (7.27%).
- 术前营养支持导致HAEC绝对风险降低21.82% (p=0.003).
- 在PNS组中没有报告任何不良事件.
结论:
- 术前营养支持是一种有效的策略,可以减少小儿高血压慢性病患者在术后拉透手术中早期HAEC的发生率.
- 这种干预提供了显著的保护作用,防止HSCR手术的重大并发症.
- 在治疗儿科HSCR患者时,应考虑优化手术前营养.
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