在患有状细胞疾病的儿童中,术后结果和状细胞危机:一项回顾性观察性研究
Max M Feinstein1, Ling Guo1, Anthony Habib1
1Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Paediatric anaesthesia
|January 20, 2026
概括
患有状细胞疾病 (SCD) 的儿童经历了手术后更长的住院时间和更高的输血率. 围手术时发生的状细胞危机发生在17.5%的儿科SCD患者中,特别是在非选择性病例中.
科学领域:
- 儿科手术 儿科手术
- 血液学 血液学 血液学
- 公共卫生 公共卫生
背景情况:
- 状细胞病 (SCD) 影响10万美国人,不成比例地影响黑人.
- 术前并发症,如低氧化和低热,可以引发形,导致SCD患者的不良结果.
- 这些结果包括疼痛危机,急性胸部综合征和中风,强调需要仔细的术后管理.
研究的目的:
- 评估患有SCD的儿科患者的术后结果.
- 在住院外科手术过程中识别状细胞危机的风险因素.
- 为了比较SCD和没有SCD接受手术的儿童之间的结果.
主要方法:
- 使用医疗保健成本和利用项目 (HCUP) 儿童住院患者数据库 (2003-2019) 的回顾性队列研究.
- 包括接受胆囊切除,尾切除,先天性心脏手术或后脊柱融合的18岁以下儿童.
- 使用多变量回归方法,在患有SCD和没有SCD的儿童之间比较结果 (停留时间,输血,并发症).
主要成果:
- 患有SCD的儿童手术后停留时间 (LOS) 较长 (aIRR: 1.29) 并且更有可能接受输血 (aRR: 13.1).
- 没有观察到血液学或传染性并发症的显著增加.
- 状细胞危机发生在17.5%的SCD患者中,非选择性入院的几率超过三倍 (aOR3.36),并且与较长的LOS相关.
结论:
- 与非SCD同龄人相比,接受手术的儿科SCD患者经历了更长的术后LOS和更高的输血率.
- 周围手术时发生的状细胞危机是一个重大问题,影响了超过16%的入院病例,在非选择性手术中更为普遍.
- 这些发现强调了为患有SCD的儿童提供量身定制的术后护理的重要性.
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