立即登录 | 免费注册
全部学科 | 内科学 | 心血管病学 | 内分泌学与糖尿病 | 神经病学 | 消化病学 | 呼吸病学 | 肿瘤学 | 妇产科学 | 骨科学
疾病中心： 高血压 | 冠心病 | 心力衰竭 | 心律失常 | 脂肪性肝病 | 糖尿病 | 卒中 | 慢性阻塞性肺病 | 子宫内膜异位症 | 乳腺癌 | 肺癌 | 结直肠癌 | 器官移植
Loading
当前位置：期刊中心 > 全球精选文摘 > 文摘导读

成人先天性心脏手术：选择成人科还是儿科机构？成人外科还是儿外科医生？

Adult Congenital Heart Surgery: Adult or Pediatric Facility? Adult or Pediatric Surgeon?
Kogon BE, Plattner C, Leong T   |    2009/5/31 18:19:25   | 
Ann Thorac Surg  |   2009   |          View at Publisher
专家评级： ★★  |    循证评级： B   |  【全球专家评论】 |   打印| 推荐给好友
上一篇： 539例Ebstein畸形患者的手术预后
下一篇： 心脏再同步化治疗（及多点起搏）在儿科及先天性心脏病中的应用：一个研究所的5年应用经验
Background:
One of the current controversies in the field of adult congenital heart disease is whether patients should be cared for at an adult or pediatric facility and by an adult or pediatric heart surgeon. After transitioning our program from the children's hospital to the adult hospital, we analyzed our experience with each system.

Methods:
Between 2000 and 2007, 303 operations were performed on adults (age≥18 years) with congenital heart disease. One hundred eighty-five operations were performed in an adult hospital and 118 in a pediatric hospital. Forty-six operations were performed by an adult heart surgeon and 257 by a congenital heart surgeon.

Results:
Mean age, coexisting medical problems, and preoperative risk factors were higher in both the adult hospital group and adult surgeon group compared with the respective pediatric groups. Mortality was similar at the adult and pediatric hospitals (4.3% versus 5.1%), but was markedly higher in the adult surgeon group compared with the pediatric surgeon group (15.2% versus 2.7%; p=0.0008). By multivariate analysis, risk factors for mortality included older age at the time of surgery (p=0.028), surgery performed at a children's hospital (p=0.013), and surgery performed by an adult heart surgeon (p=0.0004).

Conclusions:
Congenital heart surgery can be performed in adults with reasonable morbidity and mortality. Caring for an anticipated aging adult congenital population with increasingly numerous coexisting medical problems and risk factors is best facilitated in an adult hospital setting. Also, when surgery becomes necessary, these adult patients are best served by a congenital heart surgeon.
关键词:

请登录后发表评论，点击此处登录。
相关文章

关注糖尿病，聚焦GLP-1！案例征集大赛
时间：2011-3~~2011-11
由中国医师协会主办、礼来国际贸易（上海）有限公司协办、爱思唯尔国际出版集团承办的“精彩案例我分享——关注糖尿病•聚焦GLP-1”案例征集活动将于2011年3月~ 11月在全国范围隆重展开。

关注青光眼患者， 让世界更明亮！
时间：2011-4~~2011-12
《中华眼科杂志》发起，辉瑞制药资助，旨在交流青光眼治疗理念，分享国内抗青光眼药物固定联合治疗经验的病例交流活动.

聚焦哮喘和COPD联合制剂治疗
时间：2010-12~~2011-12
哮喘和慢性阻塞性肺疾病（COPD）是常见、多发的气道炎症性疾病，这类疾病严重影响患者的生活质量。我们特别组织了该类案例征集活动，奖品丰厚，快来参与！

中国选择 达标看我
时间：2011-9~~2012-9
本次活动对典型病例以分享的形式总结临床经验，通过跨专科、多层次的学术交流，对降压治疗方案、疗效进行解析与点评。

 

慢性心衰诊治：规范中求突破
黄峻
2012-2-1
南京医科大学第一附属医院
房颤治疗：手段渐趋丰富 新型治疗药物不断涌现 非药物治疗备受关注
马长生
2012-2-1
首都医科大学附属北京安贞医院
注重老年人群特征 优化管理

刘梅林
2012-2-1
北京大学第一医院老年内科