乌干达农村地区医院的手术 - - 指示,干预和结果
Jenny Löfgren1, Daniel Kadobera2, Birger C Forsberg3
1Department of Surgery and Perioperative Sciences, Umeå University, Sweden.
Lancet (London, England)
|August 28, 2015
概括
乌干达的外科手术率很低,在剖腹产等重大手术后,外科手术后死亡率很高. 需要进一步研究以减少资源有限的环境中的死亡率.
科学领域:
- 全球手术
- 公共卫生
- 手术的结果
背景情况:
- 在资源有限的环境中,特别是在非洲,仍有大量未满足的外科手术需求.
- 在手术上存在差异:全球最贫困的20亿人只接受3.5%的手术.
- 在低收入国家对手术干预,征兆和结果的前性研究稀缺.
研究的目的:
- 描述撒哈拉以南非洲一个低收入地区手术的现状.
- 分析患者的人口统计,手术和住院死亡率.
- 在资源有限的环境中建立未来手术结果研究的基线数据.
主要方法:
- 使用前性数据收集的描述性,基于设施的研究.
- 在2011年3至4个月的时间里, 从乌干达东部两家医院的41名工作人员收集了数据.
- 分析包括患者特征,干预措施,适应症和术后死亡率 (POMR).
主要成果:
- 在2701名患者中进行了2790次手术;每10万人中大手术的发生率为224. 8.
- 与怀孕相关的并发症 (66%) 和妇科疾病 (10%) 是重症手术的主要征兆,主要是女性 (88%).
- 整体POMR为0. 6% (主要手术为1. 3%,轻微手术为0. 1%),探索性腹腔切除 (13. 3%) 和剖腹产 (0. 8%) 后的高率.
结论:
- 研究环境中的手术率远低于高收入国家.
- 在特定的手术中观察到高的POMR,特别是探索性腹腔切割和剖腹产.
- 进一步调查死亡原因和护理质量对于降低低收入环境中的POMR至关重要.
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