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英格兰的儿童唇腭裂的医院治疗。

Hospital care of children with a cleft in England.

机构信息

Clinical Effectiveness Unit, Royal College of Surgeons of England, , London, UK.

出版信息

Arch Dis Child. 2013 Dec;98(12):970-4. doi: 10.1136/archdischild-2013-304271. Epub 2013 Aug 22.

DOI:10.1136/archdischild-2013-304271
PMID:23968774
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3841806/
Abstract

OBJECTIVE

To analyse hospital admissions in the first 2 years of life among children with cleft lip and/or palate in England.

DESIGN

Analysis of national administrative data of hospital admissions.

SETTING

National Health Service hospitals.

PATIENTS

Patients born alive between 1997 and 2008 who underwent surgical cleft repair.

OUTCOME MEASURES

Number of admissions, including the birth episode, and days spent in hospital were examined. Children were analysed according to cleft type and whether or not they had additional congenital anomalies.

RESULTS

10 892 children were included. In their first 2 years, children without additional anomalies (n=8482) had on average 3.2 admissions and 13.2 days in hospital, which varied from 2.6 admissions and 9.2 days with cleft lip to 4.7 admissions and 19.7 days with bilateral cleft lip and palate (BCLP). Children with additional anomalies (n=2410) had on average 6.7 admissions and 51.4 days in hospital, which varied from 6.4 admissions and 48.5 days with cleft palate to 8.8 admissions and 67.5 days with BCLP. The mean number and duration of cleft-related admissions was similar in children without (1.6 admissions and 6.4 days) and in those with additional anomalies (1.5 admissions and 8.5 days). 35.2% of children without additional anomalies had at least one emergency admission, whereas the corresponding figure was 67.3% with additional anomalies.

CONCLUSIONS

The burden of hospital care in the first 2 years of life varied according to cleft type and presence of additional anomalies. However, cleft-specific hospital care did not differ between children with and without additional anomalies.

摘要

目的

分析英格兰唇裂和/或腭裂患儿生命最初 2 年的住院情况。

设计

对国家住院数据的分析。

设置

英国国家医疗服务体系医院。

患者

1997 年至 2008 年间出生且接受过手术修复的活产患儿。

结局测量

检查了包括分娩在内的住院人数和住院天数。根据裂隙类型以及是否存在其他先天性异常,对患儿进行了分析。

结果

共纳入 10892 名患儿。在生命最初的 2 年中,无其他异常的患儿(n=8482)平均住院 3.2 次,住院 13.2 天,其中单侧唇裂的住院次数和天数分别为 2.6 次和 9.2 天,双侧唇裂和腭裂分别为 4.7 次和 19.7 天。有其他异常的患儿(n=2410)平均住院 6.7 次,住院 51.4 天,其中单纯腭裂分别为 6.4 次和 48.5 天,双侧唇裂和腭裂分别为 8.8 次和 67.5 天。无其他异常的患儿(1.6 次和 6.4 天)与有其他异常的患儿(1.5 次和 8.5 天)的裂相关住院次数和持续时间相似。无其他异常的患儿中有 35.2%至少有一次急诊住院,而有其他异常的患儿这一比例为 67.3%。

结论

生命最初 2 年的住院负担因裂隙类型和是否存在其他异常而有所不同。然而,有无其他异常的患儿的裂相关住院治疗并无差异。

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本文引用的文献

1
Centralisation of services for children with cleft lip or palate in England: a study of hospital episode statistics.英国唇腭裂儿童服务的集中化:一项基于医院住院统计数据的研究。
BMC Health Serv Res. 2012 Jun 10;12:148. doi: 10.1186/1472-6963-12-148.
2
The effects of oral clefts on hospital use throughout the lifespan.口腔裂隙对终生医院使用的影响。
BMC Health Serv Res. 2012 Mar 9;12:58. doi: 10.1186/1472-6963-12-58.
3
Initial counselling for cleft lip and palate: parents' evaluation, needs and expectations.初次唇腭裂咨询:家长评估、需求和期望。
Int J Oral Maxillofac Surg. 2010 Mar;39(3):214-20. doi: 10.1016/j.ijom.2009.12.013. Epub 2010 Jan 15.
4
Hospital use and associated costs of children aged zero-to-two years with craniofacial malformations in Massachusetts.马萨诸塞州0至2岁颅面畸形儿童的医院使用情况及相关费用。
Birth Defects Res A Clin Mol Teratol. 2009 Nov;85(11):925-34. doi: 10.1002/bdra.20635.
5
Discharge practices, readmission, and serious medical complications following primary cleft lip repair in 23 U.S. children's hospitals.美国23家儿童医院唇裂一期修复术后的出院流程、再入院情况及严重医疗并发症
Plast Reconstr Surg. 2009 May;123(5):1553-1559. doi: 10.1097/PRS.0b013e3181a0746e.
6
Genetics of cleft lip and palate: syndromic genes contribute to the incidence of non-syndromic clefts.唇腭裂的遗传学:综合征性基因导致非综合征性唇腭裂的发生。
Hum Mol Genet. 2004 Apr 1;13 Spec No 1:R73-81. doi: 10.1093/hmg/ddh052. Epub 2004 Jan 13.
7
Outpatient cleft lip repair.门诊唇裂修复术。
Plast Reconstr Surg. 2003 Aug;112(2):381-7; discussion 388-9. doi: 10.1097/01.PRS.0000070721.78741.EB.
8
Does reduced hospital stay affect morbidity and mortality rates following cleft lip and palate repair in infancy?婴儿期唇腭裂修复术后住院时间缩短是否会影响发病率和死亡率?
Plast Reconstr Surg. 1994 Dec;94(7):911-5; discussion 916-8.
9
Early postoperative complications in primary cleft lip and palate surgery--how soon may we discharge patients from hospital?原发性唇腭裂手术的早期术后并发症——我们可以多快让患者出院?
Br J Plast Surg. 1992 Apr;45(3):232-4. doi: 10.1016/0007-1226(92)90084-b.