Bulbul Ali, Can Emrah, Bulbul Lida Gunes, Cömert Serdar, Nuhoglu Asiye
Department of Pediatrics, Division of Neonatology, Sisli Children's Hospital, Istanbul, Turkey.
Pediatr Neurosurg. 2010;46(3):199-204. doi: 10.1159/000317259. Epub 2010 Oct 21.
We aimed to evaluate the clinical features, short-term prognosis, and effect of operation time on mortality and morbidity in neonates with meningomyelocele.
This prospective study was conducted between January 2006 and December 2008. Clinical features, defective area, existence of additional anomalies, operation time, and morbidity and mortality data were recorded. The effect of operation time on mortality and morbidity was evaluated.
Patients (n = 28) were assessed during the study period. Mean birth weight, height, and head circumference were found to be 3,160 ± 582 g, 46.2 ± 3.3 cm, and 36.7 ± 4.1 cm, respectively. None of the mothers received folate supplementation. Hydrocephaly (n = 13), pes equinovarus (n = 4), pelvicalyceal ectasia (n = 4), acetabular dysplasia (n = 2), Chiari II malformation (n = 2), and hydronephrosis (n = 2) accounted for additional anomalies. The mean postnatal age for surgical operation was 3.2 ± 2.8 days; mean length of hospital stay was 10.2 ± 9.7 days. The cases operated after 72 h were hospitalized longer, received antibiotherapies for a longer duration and had higher total complication rates (p = 0.04, 0.02, and 0.01, respectively).
Surgical operation of patients with meningomyelocele within 72 h after delivery significantly reduces not only the duration of hospitalization and antibiotic usage, but also complication rates.
我们旨在评估脊髓脊膜膨出新生儿的临床特征、短期预后以及手术时间对死亡率和发病率的影响。
这项前瞻性研究于2006年1月至2008年12月进行。记录临床特征、缺损区域、是否存在其他异常、手术时间以及发病率和死亡率数据。评估手术时间对死亡率和发病率的影响。
在研究期间对28例患者进行了评估。发现平均出生体重、身高和头围分别为3160±582克、46.2±3.3厘米和36.7±4.1厘米。没有一位母亲接受叶酸补充剂。脑积水(13例)、马蹄内翻足(4例)、肾盂盏扩张(4例)、髋臼发育不良(2例)、Chiari II畸形(2例)和肾积水(2例)为其他异常情况。手术的平均出生后年龄为3.2±2.8天;平均住院时间为10.2±9.7天。72小时后进行手术的病例住院时间更长,接受抗生素治疗的时间更长,总并发症发生率更高(分别为p = 0.04、0.02和0.01)。
脊髓脊膜膨出患者在出生后72小时内进行手术不仅能显著缩短住院时间和抗生素使用时间,还能降低并发症发生率。