先天性腹壁缺损（腹裂）患儿的婴幼儿期结局。

Early childhood outcomes of infants born with gastroschisis.

机构信息

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

出版信息

J Pediatr Surg. 2013 Aug;48(8):1682-7. doi: 10.1016/j.jpedsurg.2013.01.021.

DOI:10.1016/j.jpedsurg.2013.01.021

PMID:23932607

Abstract

PURPOSE

To describe neonatal and childhood outcomes of a contemporary cohort of infants with gastroschisis.

METHODS

Observational, single center, inception cohort of children born with gastroschisis from January 2005 to December 2008.

RESULTS

Of 63 infants, 61 survived to hospital discharge and 39 were seen for follow-up. Complications included sepsis (37%), necrotizing enterocolitis (10%), parenteral nutrition related cholestasis (25%), and short bowel syndrome (13%). Of survivors, 5% had visual impairment and 10% had hearing loss. No child tested had mental delay or cerebral palsy. Early gestational age predicted death or disability (OR 0.60, 95% CI 0.38, 0.96; p=0.033). There was a high incidence of prescription medications for presumed gastroesophageal reflux (90%). Some infants continued to require tube feeds (15%). There were improvements in longitudinal growth reflected in increasing z-scores.

CONCLUSIONS

Although children with gastroschisis are at risk for disability, childhood outcomes are encouraging.

摘要

目的

描述先天性腹壁裂患儿的新生儿期和儿童期结局。

方法

观察性、单中心、2005 年 1 月至 2008 年 12 月出生的先天性腹壁裂患儿的连续队列研究。

结果

63 例患儿中，61 例存活至出院，39 例接受随访。并发症包括败血症（37%）、坏死性小肠结肠炎（10%）、肠外营养相关胆汁淤积（25%）和短肠综合征（13%）。幸存者中，5%有视力障碍，10%有听力损失。无患儿智力迟钝或脑瘫。早期妊娠会增加死亡或残疾的风险（OR 0.60，95%CI 0.38，0.96；p=0.033）。由于推测存在胃食管反流，90%的患儿需要处方药物治疗。一些患儿仍需接受管饲（15%）。纵向生长的改善反映在 Z 评分的增加。