Akar Najwa Ali, Adekile Adekunle
Department of Pediatrics, Mubarak Al-Kabeer Hospital, Kuwait University, Kuwait.
Med Princ Pract. 2008;17(5):404-8. doi: 10.1159/000141506. Epub 2008 Aug 6.
This study was designed to document the common causes and patterns of hospitalization among sickle cell disease (SCD) patients in Kuwait.
The case files of all SCD patients admitted to the hospital between 1995 and 2004 were studied. Their personal data, hemoglobin genotype, diagnosis on admission, complete blood count, treatment received, length of stay and outcome were documented.
Fifty SCD patients aged from 10 months to 14.8 years (mean: 8.7 +/- 2.8 years) had 351 admissions over the 10-year period accounting for 0.6% of all admissions to the pediatric wards. The 50 patients were made up of 18 Hb SS, 28 S beta(0)thal and 4 Hb SD patients. Common causes of admission were vaso-occlusive crisis: 222 (63.2%), acute splenic sequestration crisis: 32 (9.1%), hemolytic crisis: 31 (8.8%) and acute chest syndrome: 23 (6.6%). Stroke was seen in only 1 patient, and bacteriologically proven (Salmonella) acute osteomyelitis in 1 patient. There were no deaths during the study period.
Vaso-occlusive crisis was the commonest cause of hospitalization among our SCD patients. Efforts should be intensified to give advice on preventive measures. The use of hydroxyurea should be encouraged in patients with frequent severe pain crises.
本研究旨在记录科威特镰状细胞病(SCD)患者住院的常见原因及模式。
对1995年至2004年间入院的所有SCD患者的病历进行研究。记录他们的个人资料、血红蛋白基因型、入院诊断、全血细胞计数、接受的治疗、住院时间及结局。
50例年龄从10个月至14.8岁(平均:8.7±2.8岁)的SCD患者在10年期间共入院351次,占儿科病房所有入院病例的0.6%。这50例患者包括18例Hb SS型、28例Sβ⁰地中海贫血型和4例Hb SD型患者。常见的入院原因有:血管阻塞性危机:222次(63.2%),急性脾滞留危机:32次(9.1%),溶血危机:31次(8.8%),急性胸综合征:23次(6.6%)。仅1例患者发生中风,1例患者经细菌学证实(沙门氏菌)患有急性骨髓炎。研究期间无死亡病例。
血管阻塞性危机是我们研究中SCD患者住院的最常见原因。应加大力度提供预防措施建议。对于频繁发生严重疼痛危机的患者,应鼓励使用羟基脲。