Yagi M, Kohno M, Asagiri K, Ikeda T, Okada T, Kanada S, Kawashima S, Goto Y, Takano S, Yasufuku M, Wada M
Committee of Academic Survey and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kururme-City, Fukuoka, 830-0011, Japan.
Pediatr Surg Int. 2015 Oct;31(10):955-62. doi: 10.1007/s00383-015-3775-z. Epub 2015 Aug 30.
To discuss the chronological changes observed in a national survey of neonatal surgery in Japan performed every 5 years by the Committee in the Japanese Society of Pediatric Surgeons.
We analyzed the data obtained for 20 years from 1993 to 2013 and herein report the chronological changes.
The number of summarized cases was least in 1993, with 2806 cases, and subsequently increased to 3753 cases in 2013. The mortality rate among the patients with maternal transport linearly decreased (p = 0.0386). Although the proportion of extremely low birth weight infants linearly increased (p = 0.0014), with an annual rate of +0.39 %, the mortality rate linearly decreased (p = 0.0010), with an annual rate of -1.68 %. Moreover, the overall mortality rate linearly decreased (p = 0.0002), with an annual rate of -0.26 %. Most diseases were observed to exhibit a decline in the mortality rate with the same trend as overall mortality. The decline in the mortality rate was most robust with respect to congenital diaphragmatic hernia (CDH). The mortality rates, except for that of CDH, omphalocele, esophageal atresia, and intestinal perforation, declined to 5 % or lower by 2013.
The present findings may be the result of remarkable progress in perinatal management.
探讨日本小儿外科学会委员会每5年进行一次的日本全国新生儿外科调查中观察到的时间变化。
我们分析了1993年至2013年20年间获得的数据，并在此报告时间变化情况。
汇总病例数在1993年最少，为2806例，随后在2013年增加到3753例。产妇转运患者的死亡率呈线性下降（p = 0.0386）。尽管极低出生体重儿的比例呈线性增加（p = 0.0014），年增长率为+0.39%，但其死亡率呈线性下降（p = 0.0010），年增长率为-1.68%。此外，总体死亡率呈线性下降（p = 0.0002），年增长率为-0.26%。大多数疾病的死亡率呈下降趋势，与总体死亡率趋势相同。先天性膈疝（CDH）的死亡率下降最为显著。到2013年，除CDH、脐膨出、食管闭锁和肠穿孔外，其他疾病的死亡率均降至5%或更低。
目前的研究结果可能是围产期管理取得显著进展的结果。
