Department of Pediatrics, Dokkyo Medical University School of Medicine, Kitakobayashi 880, Mibu, Tochigi, 321-0293, Japan.
Cell Biochem Biophys. 2012 Jul;63(3):191-8. doi: 10.1007/s12013-012-9355-0.
Intensive treatment for newborns with trisomy 13 is controversial because of their lethal prognosis. We report the better life prognosis of patients with trisomy 13 who received intensive treatment. At our hospital, we provided an intensive management to such patients including resuscitation and surgical procedures as required. Herein, we present the results of a retrospective study (1989-2010) of 16 trisomy 13 cases who received an intensive treatment. None was diagnosed to have trisomy 13 before birth; 9 were delivered by C-section and oxygen was administered to all patients during postpartum resuscitation. Mechanical ventilation was used in 9 patients after tracheal intubation and tracheotomy was performed in 2 patients when withdrawing of extubation was difficult. Regarding prognosis, 9 patients died, 3 were referred to another hospital, and 4 were discharged from the hospital. Four and 7 patients died within 7 and 30 days after birth, respectively. Nine patients survived for >1 month, 7 for >180 days, and 5 for >3 years. Median survival for 16 patients was 733 days. The patients who received intensive treatments survived longer compared to the previous data. This study provides useful information concerning genetic counseling, especially from an ethical point of view, before providing intensive management to newborns with trisomy 13.
对三体 13 型新生儿进行强化治疗存在争议，因为其预后致死率较高。我们报告了接受强化治疗的三体 13 型患者预后更好。在我院，我们对这些患者提供强化管理，包括必要的复苏和手术。在此，我们回顾性研究了 1989 年至 2010 年期间 16 例接受强化治疗的三体 13 型病例的结果。这些患儿出生前均未诊断为三体 13 型，9 例经剖宫产分娩，所有患儿在产后复苏期间均吸氧。9 例患儿在气管插管后进行机械通气，2 例在拔管困难时进行气管切开术。预后方面，9 例患儿死亡，3 例转院，4 例出院。4 例和 7 例患儿分别在出生后 7 天和 30 天内死亡。9 例患儿存活超过 1 个月，7 例存活超过 180 天，5 例存活超过 3 年。16 例患儿的中位生存时间为 733 天。与既往数据相比，接受强化治疗的患儿存活时间更长。本研究为遗传咨询提供了有用的信息，尤其是从伦理角度出发，为新生儿提供强化治疗之前。
