大規模な選択性大腸がん手術後の患者における術後の結果の指標として,飲酒,食事,運動 (DrEaMing):前向きなコホート研究
Mariët Faasse1, Imogen Fecher-Jones2, James M Otto3
1Department of Anesthesiology, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
まとめ
結腸直腸手術後の機能回復は,患者の飲酒,食事,運動量 (DrEaMing) によって最もよく測定されます. 術後3日目までにDrEaMの投与が失敗すると,入院期間が長くなり,罹病率が増加します.
科学分野:
- 手術 結果 研究
- 患者 を 中心 に する 治療
- 術後の回復指標
背景:
- 機能回復は 手術後の患者中心の 重要な結果です
- 英国では,早期回復を測定するためにDrEaMing (飲酒,食事,動員) 評価を用いる.
- DrEaMingの評価の有効性と最適なタイミングは十分に確立されていません.
研究 の 目的:
- 結腸直腸外科手術の患者を評価する.
- DrEaMingと入院期間 (LOS) と罹患率との関連を決定する.
- DrEaMingパターンの予測を特定するために.
主な方法:
- 360人の結腸直腸外科手術患者のコホートは,最初の3日間にわたって研究されました.
- 長期のLOS (> 中央値) と有意な罹患率 (Clavien- Dindo ≥ II) に関してDrEaMingパターンを分析した.
- DrEaMingの予測値について,手術前および手術中の変数を評価した.
主要な成果:
- 一日にDrEaMingを達成した患者の63. 3%が,その後の日に継続した.
- 術後3日目にDrEaMingを達成しなかったことは,長時間のLOS (> 6日) と有意な罹病率と強く関連していました.
- 手術の期間と 手術アプローチは DREAM のパターンを予測した.
- DrEaMingを中止した患者には,著しく長いLOSと高い罹病率がありました.
結論:
- DrEaMingは,選択性大腸直腸外科手術における回復を評価するための有効な患者中心の結果測定法です.
- 術後3日までにドレアミングが達成できなければ,またはドレアミングが再発すると,有害な結果が生じます.
- DrEaMingの導入は 伝統的な指標を超えて 手術による回復のモニタリングを強化します
関連する概念動画
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
170
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
170
01:25Endoscopic Procedures II: Colonoscopy
183
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
183
01:29Appendicitis-II: Diagnostic Studies and Management
145
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
145
01:23Peripheral Artery Disease V: Postoperative Nursing Management
24
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
24
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
346
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
346
01:22Aneurysm IV: Nursing Management
20
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
20