胃口切开的顺序与腹腔关节的替换 - - 这有什么意义吗?
Syed I Khalid1, Daniel Deysher1, Harsh Khilwani1
1Department of Neurosurgery, University of Illinois at Chicago, Chicago , Illinois , USA.
Neurosurgery
|June 7, 2023
概括
对于需要进行腹腔关突变 (VPS) 和胃口切除术的患者,同时进行两者或首先进行胃口切除术可以降低修订率. 在VPS之前的胃口切除也降低了感染风险.
科学领域:
- 神经外科 神经外科
- 胃肠病学 胃肠病学
- 医疗器械植入医疗器械植入
背景情况:
- 神经损伤往往需要腹腔关节 (VPS) 和胃口为营养支持.
- 这些手术的最佳时机仍在讨论中,因为人们担心会出现分流感染和排离.
研究的目的:
- 确定在成年患者中放置腹腔关管和胃口管的理想顺序.
- 评估程序序列对修订和感染率的影响.
主要方法:
- 对15天内接受VPS和胃口术的成年患者全付费者数据库的分析 (2010年1月 - 2021年10月).
- 根据手术的顺序分组患者:VPS前胃口术,当天,或VPS后胃口术.
- 主要结局 (修订和感染率) 被评估到30个月后移动.
主要成果:
- 同时进行VPS和胃口切除的安置,与VPS后的胃口切除相比,修订率明显较低 (OR 0.61).
- 与VPS后的胃口相比,VPS前的胃口修复也导致更低的修订率 (OR 0.61) 和明显更低的感染率 (OR 0.46),相比于VPS后的胃口修复.
- 两组之间没有观察到机械并发症或位位移率的显著差异.
结论:
- 同时执行腹腔膜外置和胃口切除手术或在外置前放置胃口切除手术可能会降低修订率.
- 在腹腔关节前放置胃口,提供了减少感染率的额外好处.
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