使用计算机断层扫描评估的胃位置与在重症患者中成功放置输卵管后的输卵管有关:一项回顾性观察性研究
Masashi Yokose1, Shunsuke Takaki2, Yusuke Saigusa3
1Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Japan. yokose_p12@yahoo.co.jp.
预测困难的后皮洛里克肠道输卵管 (EFT) 位置至关重要. 在盲目EFT安置前通过CT扫描评估的胃位置,可以表明成功插入初始管道的可能性.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
背景情况:
- 皮洛里后肠道养管 (EFT) 减少呼吸道并发症和机械通风的持续时间.
- 盲人EFT安置在重症监护中很常见,但经常遇到困难.
- 以前预测困难放置的方法只有在插入管子后才有效.
研究的目的:
- 评估通过手术前计算机断层扫描 (CT) 扫描估计的胃位置与盲目后皮洛里克EFT放置的困难之间的关联.
- 为了确定一个可靠的程序前预测器,成功的初始EFT安置.
主要方法:
- 追溯分析453名患者 (≥20年) 在重症监护室接受后皮洛里克EFT.
- 后勤回归分析,以评估成功的EFT初始安置与CT上术前胃位置之间的关联.
- 两个胃位置切线值的比较:尾部到L1-L2和通过接收器运行特征曲线分析确定的最佳切线值.
主要成果:
- 最初的EFT安置成功率为43.5%.
- 胃位置尾部到L1-L2显示出与困难放置相关的趋势 (调整后的赔率比率为0.61).
- 胃位置尾部至L2-L3,被确定为最佳切线,是最初EFT放置失败的独立因素 (调整后的几率比率,0.55).
结论:
- 胃部位置的手术前CT评估与初始后皮洛里克EFT安置的成功有关.
- 脊柱水平L2-L3作为最佳切断对胃的较大曲率来预测EFT放置的成功或失败.
- 这一发现允许在手术前识别可能遇到困难EFT安置的患者.
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