Guiney E J, Fitzgerald R J, Goldberg C
Z Kinderchir. 1984 Dec;39 Suppl 2:114-6. doi: 10.1055/s-2008-1044300.
The management policy at Our Lady's Hospital for Sick Children, Crumlin, for newborn spina bifida infants consists of immediate operation for those considered likely to benefit and full nursery care for those who do not have early surgery. In the eleven years since this policy was first implemented, there have been 493 infants admitted with open myelomeningocele, of whom 260 (52.7%) were managed non-operatively. The mortality for all infants so managed was 78% at one year. 171 (66%) of this group died without further intervention. 89 (34%) survived long enough for some form of treatment to be instituted. 41 of these children are still alive and it is felt that their handicaps have not been increased by their early management. It is argued that an approach to management which considers the needs and interests of the individual infant is more acceptable than one that seeks to enforce total care, regardless of circumstances, or the impersonal assignment, by criteria, into "treatment" and "non-treatment" groups.
对于那些被认为可能受益的婴儿立即进行手术，对于那些不进行早期手术的婴儿则提供全面的护理。自该政策首次实施的十一年来，共有493例开放性脊髓脊膜膨出婴儿入院，其中260例（52.7%）接受了非手术治疗。所有接受这种治疗的婴儿一岁时的死亡率为78%。该组中有171例（66%）未经进一步干预死亡。89例（34%）存活时间足够长，可以进行某种形式的治疗。其中41名儿童仍然活着，并且人们认为他们的残疾并没有因早期治疗而加重。有人认为，一种考虑到单个婴儿的需求和利益的管理方法比那种不顾情况寻求强制执行全面护理，或者根据标准将婴儿客观地划分为“治疗”和“非治疗”组的方法更可接受。
