肝硬化患者的开放式或皮肤外气管切除术:对全国数据库的分析
Maru Kim1,2, Timothy Allison-Aipa1, Bishoy Zakary1
1Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, Moreno Valley, CA, USA.
The American surgeon
|June 2, 2023
概括
开放式气管切除术 (OT) 与肝硬化患者的皮肤通气管切除术 (PT) 相比,与更多的并发症有关. 穿皮疗法可能更安全,特别是对于那些患有不补偿性肝硬化的人来说.
科学领域:
- 医学研究 医学研究
- 外科手术的结果
- 胃肠病学 胃肠病学
背景情况:
- 气管切除术在肝硬化需要机械通风的患者中很常见.
- 在这个人群中,指导选择气管切除术类型的证据有限.
研究的目的:
- 在肝硬化患者中,比较开放式气管切除术 (OT) 与穿皮气管切除术 (PT) 的安全性和有效性.
- 为了确定最优的气管切除术方法,以减少这组患者的并发症.
主要方法:
- 从2016年至2018年对国家住院样本 (NIS) 数据库的回顾性分析.
- 包括患有肝硬化,因呼吸衰竭而接受气管切除术的成年患者.
- 在OT和PT组之间比较并发症率和临床结果,包括对补偿性 (CC) 和不补偿性 (DC) 肝硬化症的子组分析.
主要成果:
- 开放式气管切除术 (OT) 与皮穿式气管切除术 (PT) 相比,与整体气管切除术相关的并发症 (TC),出血 (HC) 和其他并发症 (OC) 的发生率明显更高.
- 多变量分析证实OT是TC,HC和OC的风险因素.
- 在不补偿性肝硬化 (DC) 患者中,OT与PT相比也显示了TC,HC和OC的增加.
结论:
- 开放式气管切除术 (OT) 与肝硬化患者的并发症发病率较高有关.
- 穿皮气管切除术 (PT) 方法似乎是一个更安全的选择,特别是在可行的情况下,对于缺乏补偿的肝硬化患者来说.
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