Acute chest syndrome (ACS) is a leading cause of death from sickle cell disease worldwide accounting for about 25% of all deaths. The aim of this study was to determine the prevalence, clinical features and outcome in...Acute chest syndrome (ACS) is a leading cause of death from sickle cell disease worldwide accounting for about 25% of all deaths. The aim of this study was to determine the prevalence, clinical features and outcome in Port Harcourt, Nigeria. Materials and Methods: A retrospective cohort study during a five year period. Records of all patients with sickle cell anaemia (SCA) admitted into the Wards were examined. Those enrolled for the study satisfied two criteria: 1) lower respiratory tract symptoms and 2) new pulmonary infiltrates on the chest radiograph. Sociodemographics, genotype, clinical and laboratory features, treatment given and outcome were obtained. Data were analysed by descriptive statistics. Variables were compared by students’ t-test. P value ≤ 0.05 was regarded as significant. Results: A total of 345 children with sickle cell anaemia were admitted during the 5 year period. Twelve of them had acute chest syndrome (3.5%). Majority 7 (58.3%) of them were under 5 years. There were more males 8 (66.7%) than female 4 (33.3%). The most common clinical features were fever 12 (100%), cough 10 (83.3%), chest pain 5 (41.7%), pulmonary consolidation 12 (100%), and respiratory distress 12 (100%). The admitting diagnosis were bronchopneumonia 6 (50%), severe malaria 3 (25%) and vaso-occlusive crises 3 (25%). There were very high levels of leukocyte. Received ceftriaxone or ampicillin + gentamicin ± oral erythromycin), paracetamol 12 (100%), ibuprofen 8 (66.7%), tramadol 3 (25.0%), pentazocine 8 (66.7%) and blood transfusion 9 (75%). The average length of stay was 7 days (range 4 - 14 days). One patient died (8.3%). Conclusion: ACS is not uncommon in children with SCA in Port Harcourt. Education of parents on the need to recognize early symptoms of the disease is essential. Clinicians must be trained to correctly diagnose and manage it promptly and efficiently to avoid its related disastrous consequences.展开更多
目的:探讨喉罩全麻单孔胸腔镜胸部手术后不留置胸腔引流管的临床可行性和安全性。方法:对25例患者进行喉罩全麻单孔胸腔镜下胸部手术,且术后未留置胸腔引流管的的临床资料进行回顾性分析。观察指标:喉罩插管完成时间、手术时间、术中出...目的:探讨喉罩全麻单孔胸腔镜胸部手术后不留置胸腔引流管的临床可行性和安全性。方法:对25例患者进行喉罩全麻单孔胸腔镜下胸部手术,且术后未留置胸腔引流管的的临床资料进行回顾性分析。观察指标:喉罩插管完成时间、手术时间、术中出血量、术后并发症(气胸、血胸、皮下气肿、肺炎、切口感染、咽喉部、胃肠道并发症)、疼痛评分、住院时间、切口Ⅰ级愈合率等。结果:本组资料回顾显示25例无1例中转行开胸手术,喉罩插管完成时间(1.9±0.2)min;手术时间(31.6±10.2)min;术中出血量(15.5±1.0)m L;术后清醒时间(0.2±0.1)h,胸壁感觉异常48%;胸腔积液28%;咽喉不适12%;胸腔积气16%;皮下气肿8%;术后住院时间(3.1±1.8)d;术后0、1和2 d Wong-Baker评分分别为2.6、2.2和1.5。结论:喉罩全麻单孔胸腔镜下行胸部手术后不留置胸腔引流管,若术前严格掌握手术指征,术后疼痛明显减轻,术后感染等并发症明显减少,恢复周期缩短。展开更多
文摘Acute chest syndrome (ACS) is a leading cause of death from sickle cell disease worldwide accounting for about 25% of all deaths. The aim of this study was to determine the prevalence, clinical features and outcome in Port Harcourt, Nigeria. Materials and Methods: A retrospective cohort study during a five year period. Records of all patients with sickle cell anaemia (SCA) admitted into the Wards were examined. Those enrolled for the study satisfied two criteria: 1) lower respiratory tract symptoms and 2) new pulmonary infiltrates on the chest radiograph. Sociodemographics, genotype, clinical and laboratory features, treatment given and outcome were obtained. Data were analysed by descriptive statistics. Variables were compared by students’ t-test. P value ≤ 0.05 was regarded as significant. Results: A total of 345 children with sickle cell anaemia were admitted during the 5 year period. Twelve of them had acute chest syndrome (3.5%). Majority 7 (58.3%) of them were under 5 years. There were more males 8 (66.7%) than female 4 (33.3%). The most common clinical features were fever 12 (100%), cough 10 (83.3%), chest pain 5 (41.7%), pulmonary consolidation 12 (100%), and respiratory distress 12 (100%). The admitting diagnosis were bronchopneumonia 6 (50%), severe malaria 3 (25%) and vaso-occlusive crises 3 (25%). There were very high levels of leukocyte. Received ceftriaxone or ampicillin + gentamicin ± oral erythromycin), paracetamol 12 (100%), ibuprofen 8 (66.7%), tramadol 3 (25.0%), pentazocine 8 (66.7%) and blood transfusion 9 (75%). The average length of stay was 7 days (range 4 - 14 days). One patient died (8.3%). Conclusion: ACS is not uncommon in children with SCA in Port Harcourt. Education of parents on the need to recognize early symptoms of the disease is essential. Clinicians must be trained to correctly diagnose and manage it promptly and efficiently to avoid its related disastrous consequences.
文摘目的:探讨喉罩全麻单孔胸腔镜胸部手术后不留置胸腔引流管的临床可行性和安全性。方法:对25例患者进行喉罩全麻单孔胸腔镜下胸部手术,且术后未留置胸腔引流管的的临床资料进行回顾性分析。观察指标:喉罩插管完成时间、手术时间、术中出血量、术后并发症(气胸、血胸、皮下气肿、肺炎、切口感染、咽喉部、胃肠道并发症)、疼痛评分、住院时间、切口Ⅰ级愈合率等。结果:本组资料回顾显示25例无1例中转行开胸手术,喉罩插管完成时间(1.9±0.2)min;手术时间(31.6±10.2)min;术中出血量(15.5±1.0)m L;术后清醒时间(0.2±0.1)h,胸壁感觉异常48%;胸腔积液28%;咽喉不适12%;胸腔积气16%;皮下气肿8%;术后住院时间(3.1±1.8)d;术后0、1和2 d Wong-Baker评分分别为2.6、2.2和1.5。结论:喉罩全麻单孔胸腔镜下行胸部手术后不留置胸腔引流管,若术前严格掌握手术指征,术后疼痛明显减轻,术后感染等并发症明显减少,恢复周期缩短。
