手术评估时间对先天性腹壁裂患儿结局的影响。
Effect of time to surgical evaluation on the outcomes of infants with gastroschisis.
机构信息
Division of Pediatric Surgery, Department of Surgery, St Louis Children's Hospital, Washington University School of Medicine, St Louis, MO 63110, USA.
出版信息
J Pediatr Surg. 2012 Jun;47(6):1105-10. doi: 10.1016/j.jpedsurg.2012.03.016.
PURPOSE
Our goal is to identify the impact of time to surgical intervention on the outcomes of infants with gastroschisis.
METHODS
After institutional review board approval, we performed a retrospective review of the medical records of all infants admitted to our institution from 2001 to 2010. Transport, bowel stabilization, and closure times were defined as the time from birth to admission, admission to the first-documented operative intervention, and first operative intervention to abdominal closure, respectively. Outcomes included age at full enteral feeds, total parental nutrition days, ventilator days, and hospital length of stay. Multivariate analysis was used to identify independent predictors of the outcomes.
RESULTS
One hundred eighteen infants with gastroschisis were included in our study. Transport and bowel stabilization times were not predictive of any outcome. However, the time to abdominal wall closure and postnatal gastrointestinal complications were independently predictive of age at full enteral feeds, total parenteral nutrition days, and hospital length of stay.
CONCLUSION
Time to surgical evaluation/bowel stabilization was not predictive of any clinically relevant outcomes in infants with gastroschisis. These data demonstrate that potential benefits from prenatal regionalization of infants with gastroschisis are not supported by decreased time to operative intervention.
目的
本研究旨在探讨新生儿脐膨出患儿接受手术干预的时间对其结局的影响。
方法
本研究经机构审查委员会批准，回顾性分析了 2001 年至 2010 年期间我院收治的所有新生儿的病历资料。转运时间、肠稳定时间和关腹时间分别定义为自出生至入院时间、入院至首次记录的手术干预时间、首次手术干预至腹部关闭的时间。结局指标包括完全肠内喂养的年龄、全胃肠外营养天数、呼吸机使用天数和住院时间。采用多变量分析确定结局的独立预测因素。
结果
本研究共纳入 118 例新生儿脐膨出患儿。转运时间和肠稳定时间与任何结局均无相关性。然而，关腹时间和出生后胃肠道并发症是影响完全肠内喂养年龄、全胃肠外营养天数和住院时间的独立预测因素。
结论
手术评估/肠稳定时间与新生儿脐膨出患儿的任何临床相关结局均无相关性。这些数据表明，产前将新生儿脐膨出患儿进行区域化管理并不能通过缩短手术干预时间来获得潜在的益处。
Zotero 插件