南非布隆方丹大学学术医院新生儿病房收治的脊髓脊膜膨出患者概况

IF 0.2 Q4 PEDIATRICS
D N Pillay, P Moodley
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 Background. Myelomeningocele (MMC) is a common neural tube defect with significant sequelae. There are limited recent data on the mortality and morbidity of MMC in South Africa (SA).
 Objective. To describe the outcomes and characteristics of patients with MMC admitted to the neonatal unit at Universitas Academic Hospital (UAH) in Bloemfontein, SA.
 Methods. A retrospective, descriptive study which included 53 patients with MMC admitted to the neonatal unit between 1 January 2017 and 31 December 2019 was conducted. Electronic patient records were reviewed. Data included outcomes, length of stay, complications and maternal and infant characteristics.
 Results. The inpatient mortality rate was 11.3% (n=6/53). The median length of stay was 18 days. Notable MMC complications included hydrocephalus (88.7%; n=47/53), Chiari malformation type II (44.7%; n=21/47), lower-limb paralysis (84.9%; n=45/53), lower-limb deformities (60.4%; n=32/53), meningitis (52.8%; n=28/53), neuropathic bladder (37.7%; n=20/53) and loss of anal tone (41.5%; n=22/53). MMC repair was performed in 62.2% (n=33/53) and 27.3% (n=9/33) developed complications. Wound sepsis and breakdown were the most common complications (18.2%, n=6/33), with a median 8 days to complications. Antenatal sonar was not performed in 62% (n=31/50) of cases. MMC was detected antenatally in 20% of cases.
 Conclusion. The inpatient mortality rate in thisstudy was lower than the mortality rates reported in other low- and middle-income countries although significant morbidity was identified. A lack of quality antenatal care and access to antenatal sonars were barriers to early detection of MMC. Other healthcare system infrastructural failures may be contributory, which highlights the need for ongoing inter- sectoral collaboration for prevention, early detection and management of MMC to improve patient outcomes.
 
 
 
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 Background. Myelomeningocele (MMC) is a common neural tube defect with significant sequelae. There are limited recent data on the mortality and morbidity of MMC in South Africa (SA).
 Objective. To describe the outcomes and characteristics of patients with MMC admitted to the neonatal unit at Universitas Academic Hospital (UAH) in Bloemfontein, SA.
 Methods. A retrospective, descriptive study which included 53 patients with MMC admitted to the neonatal unit between 1 January 2017 and 31 December 2019 was conducted. Electronic patient records were reviewed. Data included outcomes, length of stay, complications and maternal and infant characteristics.
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引用次数: 0

摘要

& # x0D;& # x0D;& # x0D;& # x0D;背景。髓脊膜膨出(MMC)是一种常见的神经管缺损,有明显的后遗症。最近关于南非MMC死亡率和发病率的数据有限。目标。描述南非布隆方丹大学学术医院(UAH)新生儿病房收治的MMC患者的结局和特征。 方法。对2017年1月1日至2019年12月31日期间入住新生儿病房的53例MMC患者进行了一项回顾性描述性研究。审查了电子病历。数据包括结局、住院时间、并发症和母婴特征。 结果。住院病人死亡率为11.3% (n=6/53)。平均住院时间为18天。MMC并发症包括脑积水(88.7%);n=47/53), II型Chiari畸形(44.7%;N =21/47),下肢瘫痪(84.9%;N =45/53),下肢畸形(60.4%;N =32/53),脑膜炎(52.8%;N =28/53),神经性膀胱(37.7%;N =20/53)和肛门张力丧失(41.5%;n = 22/53)。62.2% (n=33/53)的患者进行了MMC修复,27.3% (n=9/33)出现了并发症。伤口败血症和破裂是最常见的并发症(18.2%,n=6/33),发生并发症的中位时间为8天。62% (n=31/50)的病例未进行产前声纳检查。产前检出MMC的病例占20%。 结论。本研究的住院病人死亡率低于其他低收入和中等收入国家报告的死亡率,尽管发现了显著的发病率。缺乏高质量的产前护理和获得产前声纳是早期发现MMC的障碍。其他医疗保健系统基础设施的失败可能是原因之一,这突出了需要持续的跨部门合作,以预防、早期发现和管理MMC,以改善患者的预后。& # x0D;& # x0D;& # x0D;
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Profiles of patients with myelomeningocele admitted to the neonatal unit at Universitas Academic Hospital in Bloemfontein, South Africa
Background. Myelomeningocele (MMC) is a common neural tube defect with significant sequelae. There are limited recent data on the mortality and morbidity of MMC in South Africa (SA). Objective. To describe the outcomes and characteristics of patients with MMC admitted to the neonatal unit at Universitas Academic Hospital (UAH) in Bloemfontein, SA. Methods. A retrospective, descriptive study which included 53 patients with MMC admitted to the neonatal unit between 1 January 2017 and 31 December 2019 was conducted. Electronic patient records were reviewed. Data included outcomes, length of stay, complications and maternal and infant characteristics. Results. The inpatient mortality rate was 11.3% (n=6/53). The median length of stay was 18 days. Notable MMC complications included hydrocephalus (88.7%; n=47/53), Chiari malformation type II (44.7%; n=21/47), lower-limb paralysis (84.9%; n=45/53), lower-limb deformities (60.4%; n=32/53), meningitis (52.8%; n=28/53), neuropathic bladder (37.7%; n=20/53) and loss of anal tone (41.5%; n=22/53). MMC repair was performed in 62.2% (n=33/53) and 27.3% (n=9/33) developed complications. Wound sepsis and breakdown were the most common complications (18.2%, n=6/33), with a median 8 days to complications. Antenatal sonar was not performed in 62% (n=31/50) of cases. MMC was detected antenatally in 20% of cases. Conclusion. The inpatient mortality rate in thisstudy was lower than the mortality rates reported in other low- and middle-income countries although significant morbidity was identified. A lack of quality antenatal care and access to antenatal sonars were barriers to early detection of MMC. Other healthcare system infrastructural failures may be contributory, which highlights the need for ongoing inter- sectoral collaboration for prevention, early detection and management of MMC to improve patient outcomes.
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CiteScore
0.60
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21
审稿时长
12 weeks
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