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埃塞俄比亚提格雷州梅开勒地区新生儿唇腭裂畸形的解剖学模式;环境影响的意义。

Anatomical patterns of cleft lip and palate deformities among neonates in Mekelle, Tigray, Ethiopia; implication of environmental impact.

机构信息

Department of Anatomy, College of Health Sciences, Mekelle University, P.O. Box 1674, Mekelle, Ethiopia.

出版信息

BMC Pediatr. 2019 Jul 24;19(1):254. doi: 10.1186/s12887-019-1624-2.

Abstract

BACKGROUND

Cleft lip and palate deformities are considered one of the most common birth defects of the head and neck that pose significant medical, psychosocial and financial burdens on the affected individuals and families, especially in low income communities. The etiology and pathogenesis of cleft lip and palate is complex and is known to involve genetic and/or environmental factors.

OBJECTIVE

To assess the patterns of anatomical cleft lip and palate deformities among neonates in Mekelle and Ayder Comprehensive Specialized hospitals, Tigray, Northern Ethiopia.

METHODS

A hospital-based retrospective study was conducted from May 2017 to June 2017 at Mekelle and Ayder Comprehensive Specialized hospitals, both in Mekelle city. Data was collected from all medical charts of neonates registered from 2011 to 2016 and analyzed using SPSS version 21.0 and OpenEpi software. Results were presented using tables and graphs; Chi-square test was used to look for an association between variables, odds ratio to determine the strength of association of selected variables using multinomial logistic regression model, while Fisher Exact (Clopper-Pearson) was used to compare yearly prevalence.

RESULTS

Of 37,152 neonatal charts analyzed, 119 (0.32%) cases were identified as having cleft deformities. 38.7, 17.6, and 43.7% of this figure had cleft lips, cleft palates and both cleft lip and palate respectively. 46 (38.7%) neonates had lateral patterns of cleft lip deformities with 56.5% located unilaterally on the right and 43.5% unilaterally on the left. Of 52 (43.7%) neonates with cleft lip and palate deformities, 40.4% were located bilaterally while 38.5 and 21.2% were located unilaterally on the left and right, respectively. Associated malformations were: cardiac (3.4%), central nervous system (1.7%) and limb deformities (5.9%). The overall prevalence of cleft deformities was found to be 3.11 per 1000 live births.

CONCLUSION

The study showed a higher prevalence of cleft deformities than that reported in Addis Ababa and some other African countries. A higher occurrence of left unilateral pattern of cleft lip and palate was observed whereas a higher right unilateral pattern of cleft lip was identified. The higher prevalence of cleft lip and palate recorded in this region of Ethiopia may reflect an environmental impact.

摘要

背景

唇腭裂畸形被认为是头颈部最常见的先天畸形之一,给患者及其家庭带来了巨大的医疗、心理社会和经济负担,尤其是在低收入社区。唇腭裂的病因和发病机制复杂,已知涉及遗传和/或环境因素。

目的

评估提格雷州梅开勒和阿德尔综合专科医院新生儿唇腭裂畸形的解剖模式。

方法

2017 年 5 月至 6 月,在梅开勒市的梅开勒和阿德尔综合专科医院进行了一项基于医院的回顾性研究。从 2011 年至 2016 年登记的所有新生儿病历中收集数据,并使用 SPSS 版本 21.0 和 OpenEpi 软件进行分析。结果以表格和图表表示;卡方检验用于寻找变量之间的关联,优势比用于使用多项逻辑回归模型确定选定变量的关联强度,而 Fisher 精确检验(Clopper-Pearson)用于比较年度患病率。

结果

在分析的 37152 份新生儿图表中,发现 119 例(0.32%)有唇腭裂畸形。其中 38.7%、17.6%和 43.7%分别为唇裂、腭裂和唇腭裂。46 例(38.7%)新生儿有唇裂侧位畸形,56.5%位于右侧单侧,43.5%位于左侧单侧。在 52 例唇腭裂畸形的新生儿中,40.4%位于双侧,38.5%和 21.2%分别位于左侧和右侧单侧。相关畸形为:心脏(3.4%)、中枢神经系统(1.7%)和肢体畸形(5.9%)。唇腭裂畸形的总患病率为每 1000 例活产儿 3.11 例。

结论

该研究显示唇腭裂畸形的患病率高于亚的斯亚贝巴和其他一些非洲国家的报告。观察到左侧单侧唇裂和腭裂的发生率较高,而右侧单侧唇裂的发生率较高。在埃塞俄比亚这一地区记录的唇腭裂较高患病率可能反映了环境的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cdb/6657112/617b9af7acb0/12887_2019_1624_Fig1_HTML.jpg

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