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健康与高危儿科人群中乳胶过敏的对比分析。

A comparative analysis of latex allergy in the healthy versus high-risk pediatric population.

作者信息

Faust K, Shrewsbury C, Zaglaniczny K, Jarrett M

机构信息

Henry Ford Hospital/University of Detroit Mercy Graduate Program of Nurse Anesthesia, USA.

出版信息

AANA J. 1999 Oct;67(5):461-6.

Abstract

Allergic or hypersensitivity reactions to natural latex have been reported with increasing frequency. Many specific populations have been identified as high risk for latex sensitivity. This research focused on the pediatric surgical population. Previous research had identified children with spina bifida, children requiring bowel or bladder programs, children with a history of atopy, and children with multiple surgical exposures as high risk. The purposes of this study were to identify the prevalence of latex sensitivity in the healthy pediatric population, to compare the incidence with that of an identified high-risk population, and to determine if a survey of known risk factors for latex sensitivity was predictive of positive serum latex antibody. This was a prospective, descriptive correlational study utilizing a convenience sample size of 400 pediatric patients aged 1 to 18 years, conducted at Henry Ford Hospital and Children's Hospital of Michigan. Children were identified as high or low risk from the survey results, and all had AlaSTAT latex allergy testing (Diagnostic Products Corporation, Los Angeles, Calif). The survey was not predictive for the positive serum latex antibody. The incidence of latex sensitivity was found to be greater in the high-risk group (17.3%) than in the general pediatric population (8.6%) using the chi 2 test (P = .01). Latex-reduced environments for children likely to have repeated latex exposure may decrease the risk of reaction and more importantly decrease sensitization for them. From an anesthetic standpoint, a fairly standard preoperative question is, "What are the number and types of surgeries a patient has undergone in the past?" This information can alert the healthcare worker to how much exposure the child has had and whether a latex-reduced environment might be required to avert a latex reaction.

摘要

据报道,对天然乳胶的过敏或超敏反应的发生频率越来越高。许多特定人群已被确定为乳胶过敏的高危人群。本研究聚焦于儿科手术人群。先前的研究已确定患有脊柱裂的儿童、需要肠道或膀胱治疗的儿童、有特应性病史的儿童以及有多次手术史的儿童为高危人群。本研究的目的是确定健康儿科人群中乳胶过敏的患病率,将其发病率与已确定的高危人群进行比较,并确定对乳胶过敏已知风险因素的调查是否能预测血清乳胶抗体呈阳性。这是一项前瞻性、描述性相关性研究,在亨利·福特医院和密歇根儿童医院进行,采用了400名年龄在1至18岁的儿科患者作为便利样本。根据调查结果将儿童确定为高风险或低风险,所有儿童都进行了AlaSTAT乳胶过敏检测(诊断产品公司,加利福尼亚州洛杉矶)。该调查不能预测血清乳胶抗体呈阳性。使用卡方检验发现,高危组乳胶过敏的发生率(17.3%)高于普通儿科人群(8.6%)(P = .01)。对于可能反复接触乳胶的儿童而言,减少乳胶接触的环境可能会降低反应风险,更重要的是会降低他们的致敏风险。从麻醉角度来看一个相当标准的术前问题是:“患者过去接受过的手术次数和类型是多少?”这一信息可以提醒医护人员该儿童接触乳胶的程度,以及是否可能需要一个减少乳胶接触的环境来避免乳胶反应。

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