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2 至 20 年脊髓脊膜膨出的随访结果:来自伊朗南部转诊中心的报告——伊朗设拉子经验

2- to 20-year myelomeningocele follow-up outcomes from a referral center in Southern Iran: the Shiraz experience.

机构信息

Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Eur J Med Res. 2024 Mar 25;29(1):200. doi: 10.1186/s40001-024-01667-0.

Abstract

BACKGROUND

The current convention for treatment of children with myelomeningocele (MMC) is timely surgical intervention combined with long-term follow-up by a multidisciplinary specialized team. This study aims to investigate the outcomes of MMC patients treated at Namazi Hospital.

METHODS

All children presenting to Namazi Hospital with myelomeningocele between May 2001 and August 2020 were eligible for this study. For those with a documented telephone number, follow-up phone surveys with the patient's caregivers, on top of the review of the medical documents were carried out to assess mortality, morbidities, and the functional outcome of the care provided to them.

RESULTS

A total of 125 patients were studied (62 females). All of the patients were followed up for a mean duration of 6.28 years (range 1-23 years). The majority were located in the lumbosacral area. All of the patients underwent postnatal surgical intervention for MMC in Namazi Hospital. Mean age at surgery was 9.51 days. There were statistically significant differences between urinary and bowel incontinence and presence of scoliosis, MMT grading of the lower limbs, school attendance, number of readmissions, and requirement of laminectomy at the initial surgical intervention.

CONCLUSIONS

This study is the first to characterize the long-term outcomes of MMC patients in Iran. This study illustrates that there is a great need for improved access to and coordination of care in antenatal, perioperative, and long-term stages to improve morbidity and mortality.

摘要

背景

目前治疗脊髓脊膜膨出(MMC)患儿的常规方法是及时进行手术干预,并由多学科专业团队进行长期随访。本研究旨在调查纳马齐医院治疗的 MMC 患者的结局。

方法

本研究纳入了 2001 年 5 月至 2020 年 8 月期间在纳马齐医院就诊的所有患有脊髓脊膜膨出的患儿。对于那些有记录的电话号码的患儿,除了审查医疗文件外,还通过电话对患儿的照顾者进行随访调查,以评估死亡率、发病率以及为他们提供的护理的功能结局。

结果

共纳入 125 例患儿(62 例女性)。所有患儿的平均随访时间为 6.28 年(范围 1-23 年)。大多数患儿病变位于腰骶部。所有患儿均在纳马齐医院接受了产后手术干预治疗 MMC。手术时的平均年龄为 9.51 天。尿失禁和大便失禁、脊柱侧凸、下肢 MMT 分级、上学情况、再入院次数以及初始手术干预时是否需要行椎板切除术之间存在统计学差异。

结论

本研究首次对伊朗 MMC 患者的长期结局进行了描述。本研究表明,迫切需要改善产前、围手术期和长期阶段的护理可及性和协调性,以降低发病率和死亡率。

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