本文選題：先天性食管閉鎖 + 病死率　； 參考：《重慶醫(yī)科大學(xué)學(xué)報》2017年08期

【摘要】：目的:構(gòu)建預(yù)測食管閉鎖(congenital esophageal atresia,CEA)新生兒院內(nèi)病死的量化評分系統(tǒng)。方法:比較2004年3月至2016年5月在重慶醫(yī)科大學(xué)附屬兒童醫(yī)院收診的198例CEA患兒相關(guān)指標(biāo),分析導(dǎo)致CEA預(yù)后不良的獨立危險因素并量化賦值。結(jié)果:CEA病死率為18.1%(n=36)。單因素分析發(fā)現(xiàn)病死組早產(chǎn)、低出生體質(zhì)量、吻合口漏、長距型CEA、呼吸衰竭、手術(shù)后敗血癥、呼吸窘迫綜合征、氣胸及休克患病率高于存活組(P0.05)。logistic回歸分析發(fā)現(xiàn)吻合口漏(OR=10.75,95%CI=3.113~37.128)、呼吸衰竭(OR=4.104,95%CI=2.292~7.355)、手術(shù)后敗血癥(OR=3.564,95%CI=1.516~8.375)、低出生體質(zhì)量(OR=8.379,95%CI=3.357~20.917)與高病死率有關(guān)(P0.05)。依據(jù)各危險變量賦值構(gòu)建的受試者工作曲線的曲線下面積為0.902,界點分數(shù)為2,靈敏度、特異度、陽性及陰性預(yù)測值分別為0.861、0.827、0.525、0.964。低危險(0~1分)、中危險(2~4分)、高危險組(≥5分)病死率分別為3.6%、49.1%、100%,3組比較差異有統(tǒng)計學(xué)意義(χ2=73.198,P=0.000)。結(jié)論:吻合口漏、呼吸衰竭、手術(shù)后敗血癥、低出生體質(zhì)量與CEA預(yù)后不良有關(guān),在總分為8分的本系統(tǒng)中,得分越高預(yù)后越差。
[Abstract]:Objective: to establish a quantitative scoring system for predicting nosocomial death of esophageal atresia esophageal atresia. Methods: from March 2004 to May 2016, 198 children with CEA were enrolled in the affiliated Children's Hospital of Chongqing Medical University. The independent risk factors leading to poor prognosis of CEA were analyzed and quantified. Results the case fatality rate of 10% CEA was 18. 1%. Univariate analysis showed premature delivery, low birth weight, anastomotic leakage, long distance CEA, respiratory failure, post-operative septicemia, respiratory distress syndrome. The prevalence of pneumothorax and shock was higher than that of survival group (P 0.05. Logistic regression analysis). The results of logistic regression analysis showed that the incidence of anastomotic leakage was higher than that of survival group (P < 0.01). Logistic regression analysis showed that the incidence of anastomotic leakage was 3.1133.113 ~ 37.88%, and that of respiratory failure was 4.104 ~ 95CI2.2927.355.The incidence of septicemia after operation was 3.56495CI1.5168.375. the lower birth weight was 8.379CI3.357CI3.3577.917) and the high mortality rate (P0.055.17). The area under the curve was 0.902, the threshold score was 2, the sensitivity, specificity, positive and negative predictive values were 0.861 / 0.827 / 0.525 / 0.964, respectively. The mortality rate in the high risk group (鈮，

本文編號：1809012