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首页> 外文期刊>Frontiers in Pediatrics >Risk Factors and Reasons for Treatment Abandonment for Patients With Esophageal Atresia: A Study From a Tertiary Care Hospital in Beijing, China
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Risk Factors and Reasons for Treatment Abandonment for Patients With Esophageal Atresia: A Study From a Tertiary Care Hospital in Beijing, China

机译：食管闭锁患者治疗遗弃危险因素及原因：中国北京市高等护理医院的研究

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Background: This study aims to identify the risk factors and reasons for treatment abandonment for patients with esophageal atresia (EA) in a tertiary care hospital in China. Methods: A retrospective study was conducted on 360 patients with EA admitted to Beijing Children's Hospital between January 1, 2007 and June 1, 2020. Medical records for treatment abandonment and non-treatment abandonment patients were compared. Univariate and multivariate logistic regression analyses were conducted to identify potential risk factors for treatment abandonment. Results: After the diagnosis of EA, parents of 107 patients refused surgical repair and discharged against medical advice, and 253 patients underwent surgical repair. Among these 253 patients, parents of 59 patients abandoned treatment after surgery; 52 patients were discharged in an unstable condition, and parents of seven patients abandoned resuscitation leading to death in the hospital. By comparing clinical characteristics between treatment abandonment before surgery ( n = 107) and non-treatment abandonment ( n = 253) groups, we found that mother's parity 1, unplanned admission to intensive care unit before surgery, associated anomalies, and Gross type A/B were significant independent risk factors for treatment abandonment before surgery. Furthermore, birth weight 133 min, admission before 2016, pneumothorax, and anastomotic leakage were significant independent risk factors for treatment abandonment after surgery. The reasons for treatment abandonment included financial difficulties, multiple malformations with poor prognosis, belief of incurability and concerns about the prognosis of the diseases, postoperative complications, and extensive length of intensive care unit stay. Conclusions: Treatment abandonment of children with EA/TEF is still a common and serious problem in China. This study showed that EA/TEF patients in critical conditions, with associated anomalies, Gross type A/B, and who had occurrence of complications had high-risk for treatment abandonment.
机译：背景：本研究旨在确定中国第三级护理医院食管闭锁患者治疗遗传遗嘱的危险因素及原因。方法：在2007年1月1日至6月1日在2007年1月1日至6月1日在北京儿童医院接受了360名EA患者进行了回顾性研究。比较了治疗遗弃和非治疗遗弃患者的病历。进行单变量和多变量逻辑回归分析，以确定治疗遗弃的潜在风险因素。结果：EA诊断后，107名患者的父母拒绝手术修复和放出医疗建议，253名患者接受手术修复。在这253名患者中，手术后59名患者的父母遗弃; 52名患者以不稳定的病情排出，七名患者的父母被遗弃遗弃在医院中导致死亡。通过比较手术前（n = 107）和非治疗遗弃前的治疗遗弃（n = 253）组的临床特征，我们发现母亲的平价＆ 1，在手术前，相关的异常和总类型的强化护理单元。 A / B是手术前治疗遗弃的显着独立风险因素。此外，出生体重133分钟，2016年之前入院，气胸和吻合渗漏是手术后治疗遗弃的显着独立的危险因素。治疗遗弃的原因包括财务困难，预后不良的多种畸形，对疾病预后，术后并发症和广泛的重症监护单位留下的不良和担忧。结论：遗弃遗传遗传们在中国仍然是一个共同和严重的问题。本研究表明，EA / TEF患者在危重条件下，具有相关的异常，A / B总型和患者的发生遗迹，治疗遗弃的高风险。

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