Hall Nigel J, Eaton Simon, Pierro Agostino
Department of Paediatric Surgery, UCL Institute of Child Health, London UK.
Early Hum Dev. 2009 Nov;85(11):713-8. doi: 10.1016/j.earlhumdev.2009.08.058. Epub 2009 Sep 12.
The practise of evidence based medicine means integrating the clinical expertise with the best available external clinical evidence from systematic research. There is a lack of supporting scientific evidence from rigorous trials in neonatal surgery. The indications for surgery and the type of operation performed in neonates are rarely supported by randomised controlled trials. As a consequence, the majority of the operations performed in neonates are supported by retrospective studies and surgeon preference. This review article is focussed on operations in neonates which are performed by general paediatric surgeons. Only a few randomised controlled trials have been performed in neonatal diseases such as congenital diaphragmatic hernia, necrotizing enterocolitis, pyloric stenosis and inguinal hernia. All of these trials have been based on collaboration between paediatric surgical units highlighting the importance of creating a network of centres that will promote multicentre prospective studies.
循证医学的实践意味着将临床专业知识与来自系统研究的最佳外部临床证据相结合。新生儿外科缺乏来自严格试验的科学证据支持。新生儿手术的适应症和手术类型很少得到随机对照试验的支持。因此，大多数新生儿手术是基于回顾性研究和外科医生的偏好。这篇综述文章聚焦于普通儿科外科医生进行的新生儿手术。在先天性膈疝、坏死性小肠结肠炎、幽门狭窄和腹股沟疝等新生儿疾病方面，仅进行了少数随机对照试验。所有这些试验都是基于儿科手术单位之间的合作，突出了建立促进多中心前瞻性研究的中心网络的重要性。
