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外科胃肠道异常,包括膈疝:异常类型是否影响神经发育结局?

Surgical gastrointestinal anomalies including diaphragmatic hernia: Does type of anomaly affect neurodevelopmental outcome?

机构信息

Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.

Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy.

出版信息

Am J Perinatol. 2014 Mar;31(3):175-80. doi: 10.1055/s-0033-1343773. Epub 2013 Apr 24.

Abstract

OBJECTIVE

To describe short-term neurodevelopmental outcome of infants operated on for congenital anomalies (CA) and assess the impact of type of CA on the outcome.

STUDY DESIGN

From 2008 to 2010 newborns operated on for CA were enrolled in a cross-sectional follow-up study including three distinct groups: infants of 6 months (group A), infants of 12 months (group B), and children of 24 months (group C). Each group was divided into five subgroups: (1) esophageal atresia; (2) congenital diaphragmatic hernia; (3) midgut malformations; (4) abdominal wall defects; (5) colorectal malformations. Each group of patients underwent a neurodevelopmental evaluation with Bayley III.

RESULTS

In all, 150, 156, and 84 babies were enrolled in groups A, B, and C, respectively. Mean (standard deviation) Mental Scale score was 94.65 (8.75), 98.76 (11.03), and 100.60 (12.04) in groups A, B, and C. Mean (standard deviation) Motor Scale score was 96.89 (11.62), 99.23 (14.83), and 103.60 (12.90) in groups A, B, and C. No significant differences were found among the five subgroups considered.

CONCLUSION

Regardless of type of malformation, short-term neurodevelopmental outcome of children with gastrointestinal anomalies including diaphragmatic hernia falls within normal range, suggesting that neither being born with a CA nor its type is per se a risk factor for neurodevelopmental delay.

摘要

目的

描述先天性畸形(CA)患儿的短期神经发育结局,并评估 CA 类型对结局的影响。

研究设计

2008 年至 2010 年,对接受先天性畸形手术的新生儿进行了一项横断面随访研究,包括三个不同的组别:6 个月龄婴儿(A 组)、12 个月龄婴儿(B 组)和 24 个月龄儿童(C 组)。每组分为五个亚组:(1)食管闭锁;(2)先天性膈疝;(3)中肠畸形;(4)腹壁缺陷;(5)结直肠畸形。每组患者均接受贝利 III 神经发育评估。

结果

共纳入 A、B、C 三组 150、156、84 例患儿。A、B、C 三组的平均(标准差)智力评分分别为 94.65(8.75)、98.76(11.03)和 100.60(12.04)。A、B、C 三组的平均(标准差)运动评分分别为 96.89(11.62)、99.23(14.83)和 103.60(12.90)。考虑到的五个亚组之间没有发现显著差异。

结论

无论畸形类型如何,包括膈疝在内的胃肠道畸形患儿的短期神经发育结局均处于正常范围内,这表明出生时存在 CA 及其类型本身并不是神经发育迟缓的危险因素。

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