Oncel Mehmet Yekta, Ozdemir Ramazan, Kahilogulları Gokmen, Yurttutan Sadık, Erdeve Omer, Dilmen Ugur
Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
J Korean Neurosurg Soc. 2012 Jun;51(6):359-62. doi: 10.3340/jkns.2012.51.6.359. Epub 2012 Jun 30.
To investigate the effect of surgery time on prognosis of newborns with meningomyelocele.
The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded.
The records of 30 babies were included in the final analysis. Overall, the mean gestational age was 37.7±2.7 weeks, with a mean birth weight of 2967±755 g and head circumference of 35.8±3.8 cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33±1.2 cm. Newborns underwent surgery on average of 8.2±5.9 days after birth, with an overall mean duration of hospital stay of 30±25.1 days. Patients were divided into two groups based on timing of surgery (group 1, ≤5 days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05).
Early surgical intervention (≤5 days) was associated with a shorter duration of hospital stay and antibiotic therapy as well as a lower complication rate. We recommend that corrective surgery be undertaken as soon as reasonably possible.
探讨手术时间对新生儿脊髓脊膜膨出预后的影响。
回顾性分析脊髓脊膜膨出新生儿的记录。记录人口统计学和临床特征以及信息、手术时间、住院时间和抗生素治疗时间。
最终分析纳入了30例婴儿的记录。总体而言,平均胎龄为37.7±2.7周,平均出生体重为2967±755 g,头围为35.8±3.8 cm。在病变部位方面,46.6%的脊髓脊膜膨出位于腰骶部,40%位于腰部,10%位于胸腰段,3.3%位于胸部。脊髓脊膜膨出囊的平均大小为4.33±1.2 cm。新生儿出生后平均8.2±5.9天接受手术,总体平均住院时间为30±25.1天。根据手术时间将患者分为两组(第1组,≤5天;第2组,>5天),组间比较显示早期手术与显著缩短的住院时间(p<0.001)和抗生素治疗时间(p<0.05)相关。
早期手术干预(≤5天)与较短的住院时间、抗生素治疗时间以及较低的并发症发生率相关。我们建议尽早进行矫正手术。