HDN

HDN
  • 文章类型: Journal Article
    背景/目的:胆汁淤积的罕见原因之一可能是胎儿和新生儿溶血病(HDFN)。方法:我们回顾性分析了88例HDFN新生儿胆汁淤积的病历和186例无胆汁淤积的HDFN患儿的病历,并进行了观察,病例控制,回顾性研究。结果:影响胆汁淤积风险的因素是出生胎龄较低(36.83±1.9vs.37.57±1.8,p=0.002),Rh或KiddHDFN(80.7%与53.2%),和需要宫内输血(27.3vs.11.8%)。受试者出生时血红蛋白浓度较低(14.01±3.8vs.16.39±2.8g/dL)和整个住院期间,脐带血总胆红素浓度(4.26±1.8vs.2.39±1.4mg/dL),较高的最大胆红素浓度(15.27±5.8vs.10.24±3.4mg/dL),和更频繁的肝脏超声异常(19.9vs.6.3%)。由于产后输血率较高,他们还需要更长时间的住院(33vs.3.8%),更频繁地需要交换输血(8.8%vs.2.2%),更长时间和更高的光疗风险(94.3vs.59.1%),和更高的免疫球蛋白使用率(55.7vs.8.1%),肠外营养(45.5vs.12.9%),和抗生素(14.8vs.4.8%)。结论:HDFN患儿发生胆汁淤积的危险因素是分娩时胎龄较低,HDFN的Rh和Kidd血清学类型,需要宫内输血.
    Background/Objectives: One of the rare causes of cholestasis may be hemolytic disease of the fetus and newborn (HDFN). Methods: We retrospectively analyzed 88 medical records of HDFN newborns with cholestasis and 186 records of children with HDFN without cholestasis and conducted an observational, case-control, retrospective study. Results: Factors influencing the risk of cholestasis were lower gestational age at birth (36.83 ± 1.9 vs. 37.57 ± 1.8, p = 0.002), Rh or Kidd HDFN (80.7% vs. 53.2%), and the need for intrauterine transfusion (27.3 vs. 11.8%). The subjects had lower hemoglobin concentrations at birth (14.01 ± 3.8 vs. 16.39 ± 2.8 g/dL) and during whole hospital stay, higher cord blood total bilirubin concentration (4.26 ± 1.8 vs. 2.39 ± 1.4 mg/dL), higher maximum bilirubin concentration (15.27 ± 5.8 vs. 10.24 ± 3.4 mg/dL), and more frequent liver ultrasound abnormalities (19.9 vs. 6.3%). They also required more extended hospitalization due to higher rates of postnatal blood transfusion (33 vs. 3.8%), more frequent need for exchange transfusion (8.8% vs. 2.2%), more extended time and higher risk of phototherapy (94.3 vs. 59.1%), and higher usage of immunoglobulins (55.7 vs. 8.1%), parenteral nutrition (45.5 vs. 12.9%), and antibiotics (14.8 vs. 4.8%). Conclusions: The risk factors for cholestasis in children with HDFN are lower gestational age at delivery, Rh and Kidd serological type of HDFN, and the need for intrauterine transfusions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    BACKGROUND: Dermatopathology reports influence clinical management, but it is not clear to what extent comments on margin involvement of histopathologically dysplastic nevi (HDN) influence decisions about re-excision or complete excision.
    OBJECTIVE: We sought to determine if standardized margin comments (MCs) on HDN influence re-excision rates.
    METHODS: By reviewing medical records, we compared re-excision rates of HDN reported with (May 2011 to December 2012) and without (January 2007 to December 2010) standardized MCs, and surveyed clinicians to assess perceptions of the impact of MCs on their management of HDN.
    RESULTS: Of 584 HDN, 302 had MCs and 282 did not. Re-excision was recommended or performed at a significantly higher rate for patients in the group without MCs (51.8%, 146 of 282) than in the MC group (39.4%, 119 of 302); P = .003 regardless of margin status. This difference was observed among HDN diagnosed as mildly and moderately dysplastic but not for severely dysplastic nevi. In all, 40% (16 of 40) of clinicians responded that they are more likely to biopsy pigmented lesions with a clinical margin of normal-appearing skin than they were before MCs were routinely included in dermatopathology reports.
    CONCLUSIONS: This was a retrospective study.
    CONCLUSIONS: Re-excision rates were significantly lower in patients who had HDN reported with standardized MCs. MCs may help reduce re-excision rates, with associated reduction in health care use, cost, and morbidity.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号