Inguinal hernia in preterm infants (≤32-week gestation)
Inguinal hernia in preterm infants (≤32-week gestation)
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DOI：
10.1007/s003830100631
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发表时间：
2002-03-01
影响因子：
1.8
通讯作者：
Hussain, N
中科院分区：
文献类型：
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作者：
Kumar, VHS;Clive, J;Hussain, N
目前早产儿腹股沟疝（IH）的发病率还没有得到很好的证实。还不清楚该人群中的常见合并症，即，慢性肺病（CLD）或营养状况或两者都有助于IH的发展。本研究的目的是建立32周胎龄（GA）或以下的早产儿出生时患有IH的流行病学概况，并确定CLD的严重程度或营养状况不良是否易患IH。还审查了接受手术的婴儿的围手术期资料。对1990年1月至1995年12月出生的1,057名23-32周GA的婴儿进行了回顾性研究。确定了特定的风险和人口统计学因素。用于确定CLD严重程度的因素包括：间歇性指令通气（IMV）天数;正压通气天数（IMV +持续气道正压通气）;以及辅助供氧总天数。通过体重增加（g/kg/天）确定总体营养状况。GA ≤ 32周的早产儿出院前入院28天以上的IH发生率为9.34%（65/696）。体重≤ 1,500 g的婴儿发生率为11.11%（63/567），体重≤ 1,000 g的婴儿发生率为17.39%（48/276）。单因素分析表明，IH患儿CLD严重程度的各项指标均具有统计学意义。在多变量回归模型中，男性是与IH显著相关的最重要变量（比值比OR = 9.6; 95%置信区间CI = 3.90-23.59），其次是辅助供氧总天数（校正OR = 1.00; 95% CI = 1.01-1.02）。两组之间的体重增加（g/kg/天）无显著差异。出院前手术矫正耐受良好。我们得出结论，IH的发病率是GA依赖性的。与CLD严重程度相关的因素在IH的易感性中起着比体重增加更重要的作用。
The current incidence of inguinal hernia (IH) in premature infants is not well-established. It is also unclear whether common co-morbidities in this population, i.e., chronic lung disease (CLD) or nutritional status or both contribute to the development of IH. The purpose of this study was to establish the epidemiologic profile of preterm infants of 32 weeks gestational age (GA) or less at birth with IH and determine whether the severity of CLD or poor nutritional status predisposes to the development of IH. Perioperative profiles of infants undergoing surgery were also reviewed. A retrospective study of 1,057 infants born at 23-32 weeks GA from January 1990 to December 1995 was done. Specific risk and demographic factors were identified. Factors used to determine severity of CLD were: days on intermittent mandatory ventilation (IMV); days on positive pressure (IMV + continuous positive airway pressure); and total number of days on supplemental oxygen. Overall nutritional status was determined by weight gain in g/kg per day. The incidence of IH in preterm infants of 32 weeks GA or less who were admitted for 28 days or more was 9.34% (65/696) prior to discharge. The incidence in infants weighing 1,500 g or less was 11.11% (63/567) and in infants 1,000 g or less 17.39% (48/276). All parameters that deter-mined the severity of CLD were statistically significant in infants with IH by univariate analysis. In a multivariate regression model, male gender was the most important variable that was significantly associated with IH (odds ratio OR = 9.6; 95% confidence interval Cl = 3.90-23.59), followed by total days on supplemental oxygen (adjusted OR = 1.00; 95% CI = 1.01-1.02). Weight gain (g/kg per day) was not significantly different between the two groups. Surgical correction before discharge was well tolerated. We conclude that the incidence of IH is GA-dependent. Factors related to severity of CLD play a more important role than weight gain in predisposing to IH.