快速-CHD途径改善了先天性心脏病新生儿的临床结果
Chenyu Li1, Zhongyuan Lu1, Shilin Wang1
1Pediatric Intensive Care Unit, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167 North Lishi Road, Xicheng District, Beijing, 100037, China.
Perioperative medicine (London, England)
|February 19, 2026
概括
RAPID-CHD路径通过确保更快地获得护理和手术,显著改善了患有严重先天性心脏病 (CCHD) 的新生儿的结果. 这种协调的系统导致CCHD婴儿的不良事件较少.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 新生儿护理 新生儿护理
- 卫生系统研究 卫生系统研究
背景情况:
- 临界先天性心脏病 (CCHD) 需要新生儿及时有效的治疗.
- 对于CCHD的传统管理模式可能会导致护理的延迟.
- 为了应对这些挑战,开发了一个协调的转介和运输系统,即RAPID-CHD路径.
研究的目的:
- 调查RAPID-CHD路径对患有心血管疾病的新生儿的影响.
- 通过RAPID-CHD途径管理的新生儿与接受传统护理的新生儿之间的结果进行比较.
- 评估协调系统在改善CCHD管理方面的有效性.
主要方法:
- 对患有慢性心脏病的新生儿 (≤28天) 的回顾性研究 (2019年1月至2024年12月).
- 第1组:RAPID-CHD路径 (产前诊断,指定分娩,快速转移).
- 第二组:常规管理 (从其他医院转诊或自我入院).
- 主要不良事件 (MAE) 被定义为医院内死亡或违背医疗建议出院.
- 后勤回归分析,以评估管理策略对MAE的影响.
主要成果:
- 其中包括587名新生儿,439人接受了手术.
- 与第二组相比,RAPID-CHD路径组 (第一组) 显示较早的ICU入院和手术.
- 第1组的出生体重较低,急诊手术较少,手术率较高.
- 主要不良事件在第一组明显较低 (5.7%对12.6%,P=0.033).
- 在手术患者 (aOR 0.36) 的调整后,RAPID-CHD路径显示了减少MAEs的趋势.
结论:
- RAPID-CHD路径增强了新生儿患有CCHD的早期获得护理和手术机会.
- 这一途径与改善结果有关,包括减少主要不良事件.
- 建议在三级儿科心脏中心更广泛地采用RAPID-CHD路径.
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