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患有先天性气管食管瘘并伴有先天性心脏异常且需接受手术治疗的新生儿的表型特征及预后

The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery.

作者信息

Hoyi Nomvuyo, Mogane Palesa, Madima Nthatheni, Motshabi Palesa

机构信息

Department of Anaesthesiology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2193, South Africa.

出版信息

Children (Basel). 2022 Jun 14;9(6):887. doi: 10.3390/children9060887.

Abstract

(1) Background: Neonates born with oesophageal atresia and/or tracheooesophageal fistula (OA/TOF) are usually born with a multitude of other congenital anomalies, which may affect their anaesthetic care and survival to hospital discharge. We reviewed the profile and outcome of neonates with OA/TOF and associated congenital cardiac anomalies presenting for surgery at an academic hospital in South Africa. (2) Methods: A retrospective, cross-sectional analysis of all medical records of neonates who had undergone surgical repair of OA/TOF was conducted at an academic hospital between January 2015 and December 2019. Descriptive statistics were used to report the data. Comparisons in perioperative events and outcomes between those with cardiac lesions and those without were done. (3) Results: Neonates presenting for OA/TOF repair with congenital cardiac defects had an incidence of 62 [95% CI 38.5-99.8] per 1000 days since birth. In total, 45.9% had associated cardiac anomalies, with PDA and ASD as the most prevalent lesions. There were statistically significant differences in intraoperative adverse events seen in neonates with congenital cardiac lesions as compared to those without. (4) Conclusion: Despite advances in neonatal critical care and anaesthetic and surgical techniques, OA/TOF associated with congenital cardiac anomalies is still associated with high mortality rates in developing countries.

摘要

(1) 背景:患有食管闭锁和/或气管食管瘘(OA/TOF)的新生儿通常还伴有多种其他先天性异常,这可能会影响他们的麻醉护理及存活至出院。我们回顾了南非一家学术医院中患有OA/TOF及相关先天性心脏异常并接受手术的新生儿的情况及预后。(2) 方法:对2015年1月至2019年12月期间在一家学术医院接受OA/TOF手术修复的所有新生儿病历进行回顾性横断面分析。采用描述性统计方法报告数据。对有心脏病变和无心脏病变的新生儿在围手术期事件和预后方面进行比较。(3) 结果:自出生起,每1000天中因先天性心脏缺陷而接受OA/TOF修复的新生儿发病率为62 [95%可信区间38.5 - 99.8]。总体而言,45.9%的新生儿伴有心脏异常,动脉导管未闭(PDA)和房间隔缺损(ASD)是最常见的病变。与无先天性心脏病变的新生儿相比,有先天性心脏病变的新生儿术中不良事件存在统计学显著差异。(4) 结论:尽管新生儿重症监护以及麻醉和手术技术取得了进展,但在发展中国家,与先天性心脏异常相关的OA/TOF仍然与高死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a62/9221898/3f32ec38316f/children-09-00887-g001.jpg

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