先天性腹壁缺损患儿的胆汁淤积和生长问题。
Cholestasis and growth in neonates with gastroschisis.
机构信息
The Department of Surgery and The Vascular Biology Program, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
出版信息
J Pediatr Surg. 2012 Aug;47(8):1529-36. doi: 10.1016/j.jpedsurg.2011.12.028.
PURPOSE
The aim of this study was to determine the incidence of cholestasis and the correlation between cholestasis and weight-for-age z scores in parenteral nutrition-dependent neonates with gastroschisis.
METHODS
A single-center retrospective review of 59 infants born with gastroschisis from January 2000 to June 2007 was conducted. Demographic and clinical data were collected and analyzed. Subjects were divided into cholestatic and noncholestatic groups. Statistical analyses included the Student t test, Wilcoxon rank sum test, Fisher exact test, and a general linear model.
RESULTS
Fifty-nine neonates with gastroschisis were identified, and 16 (28%) of 58 patients developed cholestasis. Younger gestational age and cholestasis were found to be independently associated with weight-for-age z score in 30 of 58 patients with available long-term follow-up data.
CONCLUSIONS
Parenteral nutrition-dependent neonates with gastroschisis remain at considerable risk for the development of cholestasis. Both gestational age and cholestasis were found to be independent risk factors, predisposing these neonates to poor postnatal growth.
目的
本研究旨在确定胆汁淤积症的发生率，并确定胆汁淤积症与患有先天性腹壁裂的肠外营养依赖型新生儿体重-年龄 Z 评分之间的相关性。
方法
对 2000 年 1 月至 2007 年 6 月期间在我院出生的 59 例先天性腹壁裂患儿进行单中心回顾性研究。收集并分析了人口统计学和临床数据。根据是否发生胆汁淤积将患儿分为胆汁淤积组和非胆汁淤积组。统计分析包括学生 t 检验、Wilcoxon 秩和检验、Fisher 确切检验和一般线性模型。
结果
共确定了 59 例先天性腹壁裂患儿，其中 58 例患儿中的 16 例（28%）发生了胆汁淤积。在 58 例可获得长期随访数据的患儿中，研究发现较小的胎龄和胆汁淤积与体重-年龄 Z 评分独立相关。
结论
患有先天性腹壁裂的肠外营养依赖型新生儿仍存在发生胆汁淤积的较大风险。胎龄和胆汁淤积均被发现是独立的危险因素，使这些新生儿在出生后生长不良的风险增加。
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