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先天性腹裂患儿的长期神经发育结局:决胜局。

Long-term neurodevelopmental outcomes in children born with gastroschisis: the tiebreaker.

机构信息

Division of Pediatric Surgery, Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA.

出版信息

J Pediatr Surg. 2012 Jan;47(1):125-9. doi: 10.1016/j.jpedsurg.2011.10.028.

Abstract

PURPOSE

We evaluated 2-year neurodevelopmental outcomes in children with gastroschisis.

METHODS

We reviewed the records of children with gastroschisis treated between August 2001 and July 2008. Children discharged from the neonatal intensive care unit were referred to the state-sponsored Developmental Tracking Infant Progress Statewide (TIPS) program. We reviewed TIPS assessments performed before age 2 years. School districts evaluated children referred by TIPS and determined their eligibility for early intervention services. Poor outcomes were defined as scores of "failure" or "moderate/high risk" on the screening assessment or enrollment in early intervention services by 2 years. Children with gastroschisis were compared with case-matched nonsurgical, nonsyndromic children of similar gestational age and birth weight.

RESULTS

One hundred five children were born with gastroschisis, and 46 were followed up with TIPS. There was no statistically significant difference in performance on screening assessments or in the rate of enrollment in early intervention services between the gastroschisis children and controls.

CONCLUSIONS

Children born with gastroschisis have similar 2-year neurodevelopmental outcomes as nonsurgical, nonsyndromic neonatal intensive care unit children of similar gestational age and birth weight. Both groups of children have a higher rate of enrollment in early intervention than their healthy peers. These data suggest that neurodevelopmental outcomes in gastroschisis children are delayed secondary to prematurity rather than the presence of the surgical disease.

摘要

目的

我们评估了先天性腹壁裂患儿的 2 年神经发育结局。

方法

我们回顾了 2001 年 8 月至 2008 年 7 月期间接受治疗的先天性腹壁裂患儿的病历。从新生儿重症监护病房出院的患儿被转介到州政府资助的发育跟踪婴儿进展全州计划(TIPS)项目。我们回顾了 2 岁前进行的 TIPS 评估。学区评估了 TIPS 转介的儿童,并确定他们是否有资格获得早期干预服务。不良结局定义为筛查评估中的“失败”或“中度/高度风险”评分,或在 2 岁前接受早期干预服务。将先天性腹壁裂患儿与具有相似胎龄和出生体重的非手术、非综合征的病例相匹配的对照组进行比较。

结果

共有 105 名患儿患有先天性腹壁裂,其中 46 名接受了 TIPS 随访。在筛查评估中的表现或早期干预服务的入学率方面,先天性腹壁裂患儿与对照组之间没有统计学上的显著差异。

结论

与具有相似胎龄和出生体重的非手术、非综合征新生儿重症监护病房患儿相比,患有先天性腹壁裂的患儿在 2 岁时具有相似的神经发育结局。两组患儿接受早期干预的比例都高于其健康同龄人。这些数据表明,先天性腹壁裂患儿的神经发育结局延迟是由于早产,而不是手术疾病的存在。

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