在食道切除术后早期输出管和短期结果的比例:一项回顾性队列研究
Yuki Hirano1, Takaaki Konishi2, Hidehiro Kaneko3
1Department of Hepatobiliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba.
International journal of surgery (London, England)
|June 23, 2023
概括
在医院的食道切除术后,较高比例的早期输出与较少的呼吸道并发症有关. 这表明早期输出管的策略可能会改善这种重大手术后的患者结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 手术结果研究研究.
背景情况:
- 消化管切除术后的早期输出率在医疗机构之间有很大差异.
- 医院级早期输出管术策略对患者结局的临床影响在很大程度上仍未确定.
研究的目的:
- 研究在接受食道切除手术的患者中,在医院进行的早期输出管的比例与短期临床结果之间的关联.
- 确定医院的早期输出管的策略是否会影响并发症率和资源利用率.
主要方法:
- 对日本全国性住院患者数据库 (2010年7月至2019年3月) 的回顾性分析,用于接受瘤性食道切除术的患者.
- 医院根据其早期排泄比例 (<11%至≥84%) 被分为四分位数.
- 用多变量回归和受限立方线分析来评估结果,并根据患者和医院因素进行调整.
主要成果:
- 在37,983名患者中,47%接受了早期输出管.
- 与比例很低的医院相比,早期输出管比例高和中的医院显示呼吸道并发症,再输入管和住院费用明显较低.
- 医院组之间没有观察到道泄漏或其他重大并发症的显著差异.
结论:
- 较高的医院级早期输出管的比例与食道切除术后呼吸道并发症的发病率降低有关.
- 这些发现表明,采用有利于早期输出管的全医院战略可能有利于患者的康复.
相关概念视频
Endotracheal Tube Extubation
912
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
912
Endotracheal Intubation II: Nursing Management
830
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
830
Endotracheal Intubation I: Procedure
1.8K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
1.8K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
126
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
126
Tracheostomy Decannulation
250
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
250
Esophageal Perforation-II: Clinical Manifestations and Management
94
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
94


