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低收入和中等收入国家先天性心脏病的延迟就诊:对治疗结果的影响。

Late presentation of congenital heart diseases in low- and middle-income countries: impact on outcomes.

作者信息

Das Debasis, Dutta Nilanjan, Das Shubhadeep, Ghosh Sanjiban, Chowdhuri Kuntal Roy

机构信息

Department of Cardiac Surgery, Narayana Superspeciality Hospital, 120/1 Andul Road, Howrah, 711103 India.

Department of Pediatric Cardiac Intensive Care, Narayana Superspeciality Hospital, Howrah, India.

出版信息

Indian J Thorac Cardiovasc Surg. 2025 Jun;41(6):704-717. doi: 10.1007/s12055-024-01771-0. Epub 2024 Jun 26.

Abstract

In low- and middle-income countries (LMICs), the delayed detection and presentation of congenital heart defects (CHDs) present significant hurdles, including challenges in assessing operability, unique surgical complexities during operations, and difficulties in post-operative care. Factors contributing to late detection include delayed diagnosis and referrals, limited healthcare resources, geographic barriers to specialized care, and lack of awareness leading to inappropriate medical advice. This narrative review discusses these challenges and how late presentation affects outcomes of CHDs in LMICs. A thorough assessment of operability tailored to each specific CHD, effective intraoperative strategies, and comprehensive post-operative care are crucial for achieving favourable outcomes. Current literature indicates that surgery for late-detected CHDs in LMICs can yield satisfactory results. Proper selection and management of this patient subgroup can mitigate the impact of late detection on outcomes.

摘要

在低收入和中等收入国家(LMICs),先天性心脏病(CHDs)的延迟检测和就诊带来了重大障碍,包括评估可手术性的挑战、手术期间独特的手术复杂性以及术后护理的困难。导致延迟检测的因素包括诊断和转诊延迟、医疗资源有限、获得专科护理的地理障碍以及缺乏认识导致不适当的医疗建议。这篇叙述性综述讨论了这些挑战以及延迟就诊如何影响低收入和中等收入国家先天性心脏病的治疗结果。针对每种特定先天性心脏病进行全面的可手术性评估、有效的术中策略以及全面的术后护理对于取得良好结果至关重要。当前文献表明,在低收入和中等收入国家对延迟检测的先天性心脏病进行手术可以产生令人满意的结果。对这一患者亚组进行适当的选择和管理可以减轻延迟检测对治疗结果的影响。

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