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与儿科脾脏损伤治疗方式相关的医院特征研究
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作者 Bowman S.M. zimmerman f.j. +1 位作者 Christakis D.A. 张振 《世界核心医学期刊文摘(儿科学分册)》 2006年第5期2-3,共2页
Context: Despite evidence that more than 90%of children with traumatic injuri es to the spleen can be successfully managed nonoperatively, there is significan tvariation in the use of splenectomy. As asplenic children... Context: Despite evidence that more than 90%of children with traumatic injuri es to the spleen can be successfully managed nonoperatively, there is significan tvariation in the use of splenectomy. As asplenic children are at increased ris k of overwhelming postsplenectomy infection, nonoperative management may be cons idered a quality of care indicator. Objective: To test the hypothesis that child ren are more likely to undergo splenectomy in general hospitals than in children ’s hospitals. Design: Retrospective cohort study using data from the Kid’s Inp atient Database (KID) for the year 2000. Multivariable regression was used to control for patient and hospital characteristics. Setting and Participants: All ch ildren aged 0 to 16 years who were hospitalized with a traumatic (noniatro- genic) spleen injury in nonfederal short-stay hospitals in any of the 27 stat es participating in KID (N=2851). Main Outcome Measure: Splenectomy performed wi thin 1 day of arrival. Results: A total of 11 children (3%) with splenic injuri es receiving care at children’s hospitals underwent splenectomy compared with 3 83 children (15.4%) cared for at general hospitals (P < .001). After adjusting for patient characteristics, injury severity, and hospital characteristics, sple nectomy was more likely among children treated at general hospitals (odds ratio, 5.01; 95%confidence interval, 2.21-11.36) than among children treated at chil dren’s hospitals. Conclusions: There is considerable variation in the managemen t of pediatric splenic injuries, with significantly lower rates of splenectomy a t designated children’s hospitals. Quality improvement interventions, including increased education and training for physicians in general hospitals, may be ne eded to increase the use of spleen-conserving management practices. 展开更多
关键词 儿童专科医院 脾脏损伤 治疗方式 综合性医院 住院患儿 回顾性队列研究 脾切除术 非手术治疗 儿科 质量评价指标
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经导管应用amplatzer封堵器治疗室间隔肌部缺损后出现的心脏传导异常
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作者 Robinson J.D.C. zimmerman f.j. +1 位作者 De Loera O. 柴大军 《世界核心医学期刊文摘(心脏病学分册)》 2006年第6期42-43,共2页
This study examined the incidence of cardiac conduction abnormalities and ventricular arrhythmias after the transcatheter closure of muscular ventricular septal defects(MVSDs) using the Amplatzer device occluder. From... This study examined the incidence of cardiac conduction abnormalities and ventricular arrhythmias after the transcatheter closure of muscular ventricular septal defects(MVSDs) using the Amplatzer device occluder. From the records of 27 patients who underwent 33 consecutive MVSD device closures, a low incidence of permanent and transient cardiac conduction disturbances was observed. Heart rate variability was less after the closure of multiple MVSDs compared with single MVSDs. 展开更多
关键词 AMPLATZER封堵器 传导异常 经导管 室间隔 心脏 治疗 缺损 肌部 出现 室性心律失常
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