Baerg J, Kaban G, Tonita J, Pahwa P, Reid D
Regina General Hospital, University of Saskatchewan, Saskatchewan, Canada.
J Pediatr Surg. 2003 May;38(5):771-4. doi: 10.1016/jpsu.2003.50164.
The aim of this study was to examine the incidence of gastroschisis in Saskatchewan over a 16-year period and identify risk factors associated with mortality.
Information was obtained by retrospective review of all infant charts at the only 2 provincial neonatal intensive care centers from January 1985 through December 2000. Factors recorded were gestational age, birth weight, gender, Apgar score, time to operation, method of closure, time to attain full feedings, presence of sepsis, and length of hospital stay. Live birth data for the province was obtained, and the incidence per 10,000 live births for 3 time intervals was calculated. Analysis was performed with mortality as the dependent variable.
Seventy-one infants were identified. Overall survival rate was 93% (66 of 71). During the 3 time intervals examined, the incidence of gastroschisis per 10,000 live births increased from 1.85 in 1985 to 1990 to 3.66 in 1991 to 1995 to 4.06 in 1996 to 2000. The analysis found that intestinal atresia P =.009, OR = 18.3 (95%CI: 2.457-136) and intestinal necrosis P =.050, OR = 10.33 (95%CI: 1.32-80.68) were significantly associated with mortality.
The incidence of gastroschisis is increasing. Intestinal atresia and the development of intestinal necrosis were associated with poor outcome. Patients who had these complications all had short bowel, and full feedings could not be established. They required continuation of total parenteral nutrition and experienced episodes of sepsis.
本研究旨在调查萨斯喀彻温省16年间腹裂的发病率，并确定与死亡率相关的危险因素。
通过回顾性查阅1985年1月至2000年12月该省仅有的2家省级新生儿重症监护中心的所有婴儿病历获取信息。记录的因素包括胎龄、出生体重、性别、阿氏评分、手术时间、闭合方法、完全经口喂养时间、败血症的存在情况以及住院时间。获取该省的活产数据，并计算3个时间段每10,000例活产中的发病率。以死亡率为因变量进行分析。
共识别出71例婴儿。总体生存率为93%（71例中的66例）。在研究的3个时间段内，每10,000例活产中腹裂的发病率从1985年至1990年的1.85上升至1991年至1995年的3.66，再到1996年至2000年的4.06。分析发现肠闭锁（P = 0.009，OR = 18.3，95%CI：2.457 - 136）和肠坏死（P = 0.050，OR = 10.33，95%CI：1.32 - 80.68）与死亡率显著相关。
腹裂的发病率在上升。肠闭锁和肠坏死的发生与不良预后相关。患有这些并发症的患者均有短肠，无法建立完全经口喂养。他们需要持续进行全胃肠外营养，并经历败血症发作。
