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Clinical Outcomes of Splenectomy in Children: Report of the Splenectomy in Congenital Hemolytic Anemia (SICHA) Registry

机译:儿童脾切除术的临床结果:先天性溶血性贫血(SICHA)注册表中的脾切除术的报告

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摘要

The outcomes of children with congenital hemolytic anemia (CHA) undergoing total splenectomy (TS) or partial splenectomy (PS) remain unclear. In this study, we collected data from 100 children with CHA who underwent TS or PS from 2005–2013 at 16 sites in the Splenectomy in Congenital Hemolytic Anemia (SICHA) consortium using a patient registry. We analyzed demographics and baseline clinical status, operative details, and outcomes at 4, 24, and 52 weeks after surgery. Results were summarized as hematologic outcomes, short-term adverse events (AEs) (≤ 30 days after surgery), and long-term AEs (31–365 days after surgery). For children with hereditary spherocytosis, after surgery there was an increase in hemoglobin (baseline 10.1 ± 1.8 gm/dl, 52 week 12.8 ± 1.6 gm/dl; mean ± SD), decrease in reticulocyte and bilirubin as well as control of symptoms. Children with sickle cell disease had control of clinical symptoms after surgery, but had no change in hematologic parameters. There was an 11% rate of short-term AEs and 11% rate of long-term AEs. As we accumulate more subjects and longer follow-up, use of a patient registry should enhance our capacity for clinical trials and engage all stakeholders in the decision-making process.
机译:先天性溶血性贫血(CHA)患儿接受全脾切除术(TS)或部分脾切除术(PS)的结果仍不清楚。在这项研究中,我们收集了100例2005-2013年在先天性溶血性贫血(SICHA)脾切除术中16个部位接受过TS或PS的CHA儿童的数据。我们分析了术后4、24和52周的人口统计学和基线临床状况,手术细节和结局。结果总结为血液学结果,短期不良事件(AE)(手术后≤30天)和长期AE(手术后31–365天)。对于患有遗传性球形细胞增多症的儿童,手术后血红蛋白增加(基线10.1±1.8 gm / dl,52周12.8±1.6 gm / dl;平均值±SD),网织红细胞和胆红素减少以及症状控制。镰状细胞病患儿术后可控制临床症状,但血液学参数无变化。短期AE发生率为11%,长期AE发生率为11%。随着我们越来越多的受试者和更长的随访时间,使用患者注册表将增强我们的临床试验能力,并使所有利益相关者参与决策过程。

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