オープンハート手術による弁置換手術を受ける患者の栄養状態
Lancet (London, England)
|January 14, 1978
まとめ
全身のカリウムで評価される手術前の栄養状態は,心弁置換術患者のアウトカムに影響します. 枯渇した患者は,より高い罹病率と,手術後の更なる入院期間を経験しました.
科学分野:
- 心血管外科手術についてです.
- 栄養バイオケミストリー
- 医療モニタリング
背景:
- 心弁置換手術には,しばしば心肺バイパス手術が伴う.
- 手術前栄養状態の評価は,外科手術の結果にとって極めて重要です.
- 痩せた体質は栄養状態の指標である.
研究 の 目的:
- 栄養状態の非侵襲的指標として全体カリウムの使用を評価する.
- 心弁置換手術に対する代謝反応を決定する.
- 術前栄養状態と術後の罹患率と入院期間を相関させるため.
主な方法:
- 10人の患者で全身モニターを使用して全身カリウムを非侵襲的に測定.
- 栄養状態を評価するために,カリウム測定から痩身体重を導出する.
- 手術前と術後7日目の測定値の比較.
主要な成果:
- 外科手術に対する代謝反応は,10.8g/dayのマイナスの窒素バランスを示し,従来の推定値より50%高い.
- 術前平均17.2%のポタシウム欠乏症を有する4人の患者は,罹病率の増加を示した.
- 栄養が良い患者は,手術後の平均滞在時間が16日であり,栄養が乏しい患者は平均滞在時間が30日であった.
結論:
- 全身カリウムは,心臓弁置換手術を受ける患者の栄養状態を評価するための貴重な非侵襲的指標です.
- 術前のカリウム欠乏症は,術後の罹患率の増加と長期の入院に関連しています.
- 手術前栄養評価と最適化は,心臓弁置換手術における患者のアウトカムを改善するために不可欠です.
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