2019年9月至2020年6月乌干达西南部姆巴拉拉地区转诊医院收治的严重先天性腹壁缺陷儿童的模式和短期预后

Jamal A. Mohamed, R. Migisha, Felix Oyania, A. Wesonga, A. Mohamed, Martin Situma
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引用次数: 0

摘要

背景:脐膨出和胃裂是全球最常见的先天性腹壁缺陷(CAWDs)。低收入国家重症新生儿死亡率高于高收入国家。本研究描述了在乌干达西南部一家地区转诊医院胃裂和脐膨出婴儿的模式和短期临床结果。方法:在姆巴拉拉地区转诊医院进行了为期10个月的病例系列研究。在研究期间出生的CAWD儿童连续招募了54个样本量。使用Stata version 15输入、清理和分析数据。进行描述性统计,其中连续变量使用中位数和四分位数范围进行汇总,而分类变量使用频率和比例进行汇总。采用Kaplan-Meier生存分析评估死亡时间。结果:共纳入54例新生儿,其中腹裂40例(70.04%),脐膨出14例(25.93%)。婴儿的中位年龄为9天,四分位数范围为4至21天。54例新生儿中,30例(69.2%)为1 ~ 10日龄男性。复杂性腹裂婴儿的死亡率(22)高于单纯性腹裂婴儿(10)。未使用抗生素和低出生体重是与新生儿期诊断为胃裂和脐膨出的婴儿死亡率相关的因素。结论:胃裂是最常见的缺陷,儿童胃裂死亡率普遍较高。在30天随访期内,复杂性胃裂的预后比单纯性胃裂差。在转诊到卫生机构之前未使用抗生素和低出生体重是与新生儿期诊断为胃裂和脐膨出的婴儿死亡率相关的因素。建议:观察到的最常见的类型是胃裂。大多数出现脐膨出的儿童更有可能存活30天。先天性前腹壁缺损婴儿需要及时转诊。
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Patterns and Short Term Outcome of Children with Major Congenital Anterior Abdominal Wall Defects Admitted At Mbarara Regional Referral Hospital, South Western Uganda, from September 2019 to June 2020.
Background: Omphalocele and gastroschisis are the most common major congenital abdominal wall defects (CAWDs) globally. Mortality among neonates major CAWDs is higher in low-income countries than in high-income countries. This study described the patterns and short-term clinical outcomes of infants with gastroschisis and omphalocele at a regional referral hospital in southwestern Uganda. Methods: A case series was conducted at Mbarara Regional Referral Hospital ten months. Children born with CAWD during the study period 54 samples size were consecutively recruited into the study. Data were entered, cleaned, and analyzed using Stata version 15. Descriptive statistics were performed where continuous variables were summarized using median and interquartile ranges, while categorical variables were summarized using frequencies and proportions.  Time to mortality was assessed using Kaplan–Meier survival analysis. Results:  A total of 54 newborns were recruited into the study, of which 40 (70.04%) had Gastroschisis and 14(25.93%) had omphalocele. The median age of the infants was 9 days with an interquartile range of 4 to 21days. Of the 54 newborns, 30(69.2%) were male within the age group of 1-10 days. Mortality was higher in babies with complex gastroschisis (22) than simple gastroschisis (10).  Not administering antibiotics and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period. Conclusion: The most common observed defect was gastroschisis, Mortality was generally high among children presenting with gastroschisis.  Complex gastroschisis has a poorer prognosis than simple gastroschisis over 30 days follow up period.  Non-use of antibiotics before referral to a health facility and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period. Recommendation: The most common pattern observed was Gastroschisis. The majority of children presenting with Omphalocele were more likely to survive for 30 days. There is a need for timely referral for babies born with congenital anterior abdominal wall defects.
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