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尼日利亚西南部一家教学医院脊柱裂的模式、特点及管理挑战

The pattern, peculiarities, and management challenges of spina bifida in a teaching hospital in Southwest Nigeria.

作者信息

Komolafe Edward O, Onyia Chiazor Udochukwu, Ogunbameru Ibironke O, Dada Oluwamuyiwa A, Owagbemi Oluwafemi F, Ige-Orhionkpaibima Fred S, Olarewaju Oluseun A, Obamwonyi Efosa O, Abdullahi Muhammad I

机构信息

Department of Surgery, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.

Neurosurgery division, Department of Surgery, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria.

出版信息

Childs Nerv Syst. 2018 Feb;34(2):311-319. doi: 10.1007/s00381-017-3614-8. Epub 2017 Oct 12.

Abstract

PURPOSE

Spina bifida is a common congenital anomaly of the nervous system. It is frequently associated with significant morbidity and sometimes mortality in affected children. In this paper, we review the clinico-epidemiological pattern, peculiarities, and therapeutic challenges of this condition in our practice setting.

METHODS

This is a retrospective study of all cases of spina bifida managed from July 2000 to March 2016 at a tertiary health facility located in the southwest region of Nigeria. Relevant information was retrieved from the medical records. The data was collected using a pro forma and analyzed with SPSS version 22.

RESULTS

Data from 148 patients was reviewed and analyzed. There were 78 males and 70 females. Only 5.8% of these children were delivered at the health institution. A fifth (20%) of the patients were first born of their mothers. The mean maternal age was 29 years. Few (10.1%) mothers use folate medication prior to conception and only 58% of the mothers use folate during antenatal care. Mean duration of pregnancy was 38 weeks. The most common anatomical site was lumbosacral region (74.3%) while the most common pathology was myelomeningocele 80.4%. Mean age at surgery was 88.68 h. Mean duration of surgery was 92.8 min. Mean follow-up duration was 46.8 weeks. As many as 59% of the patients had some neurologic improvement noticed during follow-up clinic visits.

CONCLUSION

Spina bifida occurs frequently in our environment. Low socio-economic status and poor antenatal clinic visits contributes significantly to its occurrence.

摘要

目的

脊柱裂是一种常见的先天性神经系统异常。它常与受影响儿童的严重发病甚至死亡相关。在本文中,我们回顾了在我们的实际医疗环境中这种疾病的临床流行病学模式、特点及治疗挑战。

方法

这是一项对2000年7月至2016年3月在尼日利亚西南部一家三级医疗机构接受治疗的所有脊柱裂病例的回顾性研究。从病历中检索相关信息。使用表格形式收集数据,并采用SPSS 22版进行分析。

结果

对148例患者的数据进行了回顾和分析。其中男性78例,女性70例。这些儿童中只有5.8%在该医疗机构分娩。五分之一(20%)的患者是其母亲的头胎。母亲的平均年龄为29岁。很少有母亲(10.1%)在受孕前服用叶酸药物,只有58%的母亲在产前护理期间服用叶酸。平均孕期为38周。最常见的解剖部位是腰骶部(74.3%),最常见的病理类型是脊髓脊膜膨出(80.4%)。手术时的平均年龄为88.68小时。平均手术时长为92.8分钟。平均随访时长为46.8周。多达59%的患者在随访门诊时神经功能有改善。

结论

脊柱裂在我们的环境中频繁发生。社会经济地位低和产前门诊就诊情况差对其发生有显著影响。

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