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婴儿肥厚性幽门狭窄:喀麦隆两个三级医疗中心的4年经验

Infantile hypertrophic pyloric stenosis: a 4-year experience from two tertiary care centres in Cameroon.

作者信息

Ndongo Rene, Tolefac Paul Nkemtendong, Tambo Faustin Félicien Mouafo, Abanda Matin Hongieh, Ngowe Marcelin Ngowe, Fola Olivier, Dzekem Bonaventure, Weledji Patrick Eroyl, Sosso Maurice Aurelien, Minkande Jacqueline Ze

机构信息

Yaounde Central Hospital, Yaoundé, Cameroon.

Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.

出版信息

BMC Res Notes. 2018 Jan 16;11(1):33. doi: 10.1186/s13104-018-3131-1.

Abstract

OBJECTIVE

This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon.

RESULTS

A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants. The diagnosis was confirmed with ultrasounds in all participants. Ramstedt pyloromyotomy was done in all participants and in 9.5% of the participants it was complicated by intra-operative duodenal perforation whereas in the postoperative period the most common complications were vomiting (6, 28.6%), sepsis (2, 9.5%), and paralytic ileus (2, 9.5%). The mortality rate from the series is 9.5%. According to univariate logistic regression: severe dehydration [OR = 5.41, 95% CI = (3.11-6.97), p = 0.002], hypokalaemia [OR = 2.63, 95% CI = (1.02-5.91), p = 0.042] and surgical site infection [OR = 3.12, 95% CI (1.22-5.64), p = 0.023] were the main predictors of mortality whereas postoperative hospital length of stay > 5 days was significantly associated with surgical site infection [OR = 2.44, 95% CI = (1.12-6.44), p = 0.002] and postoperative nausea and vomiting [OR = 3.64, 95% CI = (1.18-6.64), p = 0.022].

摘要

目的

本研究旨在描述喀麦隆两家三级医疗中心婴儿肥厚性狭窄患者的临床特征、治疗及预后情况。

结果

两个中心共纳入21例患者。就诊时的平均年龄为5.2±1.2周,以男性为主,男女比例为4.25:1。仅7例(33.3%)参与者出现呕吐、可见蠕动波和可触及肿块三联征。所有参与者均通过超声确诊。所有参与者均接受了拉姆施泰德幽门肌切开术,9.5%的参与者术中并发十二指肠穿孔,术后最常见的并发症为呕吐(6例,28.6%)、败血症(2例,9.5%)和麻痹性肠梗阻(2例,9.5%)。该系列的死亡率为9.5%。单因素逻辑回归分析显示:重度脱水[比值比(OR)=5.41,95%置信区间(CI)=(3.11 - 6.97),p = 0.002]、低钾血症[OR = 2.63,95% CI =(1.02 - 5.91),p = 0.042]和手术部位感染[OR = 3.12,95% CI (1.22 - 5.64),p = 0.023]是死亡的主要预测因素,而术后住院时间>5天与手术部位感染[OR = 2.44,95% CI =(1.12 - 6.44),p = 0.002]以及术后恶心和呕吐[OR = 3.64,95% CI =(1.18 - 6.64),p = 0.022]显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6d1/5771033/f04976bbff7e/13104_2018_3131_Fig1_HTML.jpg

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