加拿大采用和未采用多学科团队管理的腹裂患者的治疗结果。
Outcome of patients with gastroschisis managed with and without multidisciplinary teams in Canada.
作者信息
Gover Ayala, Albersheim Susan, Sherlock Rebecca, Claydon Jennifer, Butterworth Sonia, Kuzeljevic Boris
机构信息
Division of Neonatology, Pediatrics, BC Women's Hospital and Health Centre, BC Children's Hospital;
Division of Pediatric General Surgery, Surgery, Children's Hospital of British Columbia;
出版信息
Paediatr Child Health. 2014 Mar;19(3):128-32.
OBJECTIVE
To describe the outcomes of gastroschisis (GS) patients managed with and without a multidisciplinary team during the postoperative period in Canada.
METHOD
The Canadian Pediatric Surgery Network (CAPSNet) collects patient data from all Canadian tertiary perinatal centres. The outcomes of 396 GS patients born between 2005 and 2009 who were managed with and without a multidisciplinary team were analyzed.
RESULTS
Significantly more parenteral nutrition (PN) days (P=0.003) and longer lengths of stay (P=0.018) were observed among patients in centres with multidisciplinary teams. Higher mortality rate and earlier death were observed in centres without multidisciplinary teams, especially for high-risk patients, although this was not statistically significant. With regard to low-risk patients, those in centres with multidisciplinary teams had significantly more PN days (P=0.019).
CONCLUSIONS
GS patients managed by multidisciplinary teams had significantly more PN days and longer lengths of stay compared with patients who were not managed by multidisciplinary teams. This difference may be due to improved survival of high-risk patients in centres with multidisciplinary teams, and a uniform feeding approach for all patients.
目的
描述加拿大腹裂（GS）患者术后由多学科团队管理和未由多学科团队管理的结局。
方法
加拿大儿科外科网络（CAPSNet）收集了加拿大所有三级围产期中心的患者数据。分析了2005年至2009年出生的396例接受多学科团队管理和未接受多学科团队管理的GS患者的结局。
结果
在有多学科团队的中心，患者的肠外营养（PN）天数显著更多（P = 0.003），住院时间更长（P = 0.018）。在没有多学科团队的中心，尤其是高危患者，观察到更高的死亡率和更早的死亡，尽管这在统计学上不显著。对于低危患者，有多学科团队的中心的患者PN天数显著更多（P = 0.019）。
结论
与未由多学科团队管理的患者相比，由多学科团队管理的GS患者PN天数显著更多，住院时间更长。这种差异可能是由于有多学科团队的中心高危患者生存率提高，以及对所有患者采用统一的喂养方法。
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