Tikur Anbessa 专科医院新生儿重症监护室的前腹壁缺损及其处理结果

JPGN reports Pub Date : 2024-07-10 DOI:10.1002/jpr3.12110
Abebe Habtamu, Tenagne Million
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摘要

胃裂和脐膨出是常见的前腹壁畸形,可导致新生儿严重的发病率和死亡率。这项回顾性机构研究旨在评估 Tikur Anbessa 专科医院(TASH)(三级医院)新生儿重症监护室(NICU)对患有前腹壁缺损(特别是胃裂和脐膨出)的新生儿的管理结果。从新生儿重症监护室的病历中找出并检索了患有脐膨出和胃裂的新生儿病历。研究共纳入50例腹壁缺损新生儿,其中39例为脐膨出,11例为胃裂。产妇年龄从18岁到40岁不等,平均年龄为(27.6 ± 4.5)岁。33.3%的脐膨出病例和18.2%的胃裂病例伴有畸形。心脏畸形是与脐膨出相关的最常见畸形。27.3%的胃畸形病例(11 例中有 3 例)和 41%的脐膨出病例(39 例中有 16 例)接受了手术治疗。重度和轻度脐膨出的术后死亡率均为12.5%,其中11例死于胃裂。研究显示,胃裂病例的死亡率明显高于脐裂病例。脓毒症是新生儿死亡的主要原因。这些发现强调了有效的管理策略对于预防和处理腹壁缺损新生儿败血症的重要性。
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Anterior abdominal wall defects and their management outcomes in Tikur Anbessa Specialized Hospital, neonatal intensive care unit
Gastroschisis and omphalocele are common malformations of the anterior abdominal wall and can lead to significant morbidity and mortality in neonates. Despite advances in surgical care, these conditions remain challenging to manage effectively.This retrospective institutional study aimed to assess the management outcomes of neonates with anterior abdominal wall defects, specifically gastroschisis and omphalocele, in the Neonatal Intensive Care Unit (NICU) of Tikur Anbessa Specialized Hospital (TASH) (Tertiary Hospital).A retrospective review was conducted on cases of gastroschisis and omphalocele managed in the NICU of TASH from August 2018 to August 2022. Patient charts of neonates with omphalocele and gastroschisis were identified and retrieved from the NICU records. The collected data were analyzed using statistical software such as SPSS.The study included a total of 50 neonates with abdominal wall defects, consisting of 39 cases of omphalocele and 11 cases of gastroschisis. Maternal age ranged from 18 to 40 years, with a mean age of 27.6 ± 4.5 years. Associated malformations were documented in 33.3% of omphalocele cases and 18.2% of gastroschisis cases. Cardiac anomalies were the most frequently associated malformation with omphalocele. Surgical intervention was performed in 27.3% of gastroschisis cases (3 out of 11) and 41% of omphalocele cases (16 out of 39). The postsurgery mortality rate was 12.5% for both major and minor omphaloceles, with 11 deaths occurring in gastroschisis cases. Sepsis was identified as the cause of death in all neonates who did not survive.The study revealed a significantly higher mortality rate in gastroschisis cases compared to omphalocele cases. Sepsis was identified as the primary cause of death in the neonates. These findings underscore the importance of effective management strategies to prevent and manage sepsis in neonates with abdominal wall defects.
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