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腹裂新生儿的结局:分娩方式、分娩地点及出生至手术间隔时间的影响

Outcomes of newborns with gastroschisis: the effects of mode of delivery, site of delivery, and interval from birth to surgery.

作者信息

Quirk J G, Fortney J, Collins H B, West J, Hassad S J, Wagner C

机构信息

Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, 72205-7199, USA.

出版信息

Am J Obstet Gynecol. 1996 Apr;174(4):1134-8; discussion 1138-40. doi: 10.1016/s0002-9378(96)70655-5.

Abstract

OBJECTIVE

Our purpose was to determine the impact of delivery site, delivery mode, and delivery-to-surgery interval on outcomes for neonates diagnosed with gastroschisis.

STUDY DESIGN

Data were obtained retrospectively by chart review on 56 newborns diagnosed with gastroschisis. Outcome measures examined included primary closure, days to enteral feeding, days in intensive care, total length of stay, and hospital charges.

RESULTS

Inborn infants experienced fewer days to enteral feeding (p < 0.01)., shorter total lengths of hospital stay (p < 0.01), and lower hospital charges (p < 0.01). Newborns delivered by cesarean section tended to have longer lengths of stay (p = 0.07), greater hospital charges (p = 0.06), and significantly longer lengths of stay in intensive care (p = 0.05). Shorter intervals from delivery to surgery were observed for inborn neonates (p < 0.01) and for those delivered by cesarean section (p < 0.05). No relationships between hours from delivery to surgery and neonatal outcomes were observed.

CONCLUSIONS

Delivery at a regional center is associated with improved outcomes, whereas cesarean deliveries were associated with worse outcomes. We observed no salutary effect related to the interval between delivery and initial surgical repair.

摘要

目的

我们的目的是确定分娩地点、分娩方式以及分娩至手术间隔时间对诊断为腹裂的新生儿结局的影响。

研究设计

通过回顾56例诊断为腹裂的新生儿病历,进行回顾性数据收集。所检查的结局指标包括一期缝合、开始肠内喂养的天数、重症监护天数、住院总时长以及住院费用。

结果

产时新生儿开始肠内喂养的天数较少(p<0.01),住院总时长较短(p<0.01),住院费用较低(p<0.01)。剖宫产分娩的新生儿住院时长往往较长(p=0.07),住院费用较高(p=0.06),重症监护时长显著更长(p=0.05)。产时新生儿(p<0.01)以及剖宫产分娩的新生儿(p<0.05)从分娩至手术的间隔时间较短。未观察到从分娩至手术的时长与新生儿结局之间存在关联。

结论

在区域中心分娩与更好的结局相关,而剖宫产分娩与更差的结局相关。我们未观察到分娩与初次手术修复之间的间隔时间产生有益影响。

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