过度中央气道崩患者的手术前检查:支架评估是否起作用?
Jennifer M Pan1, Daniel Ospina-Delgado1, Sumedh Kaul2
1Division of Thoracic Surgery and Interventional Pulmonology, Department of Surgery.
Journal of bronchology & interventional pulmonology
|July 6, 2023
概括
气管支气管造形术 (TBP) 显著改善了严重气道崩的患者的生活质量和功能状态. 这些改善持续至手术后12个月,表明TBP.
科学领域:
- 肺部医学 肺部医学
- 胸部外科手术 胸部外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 严重的症状性呼气中心气道崩需要像气管支气管整形术 (TBP) 这样的最终干预措施.
- 虽然气道支架用于外科修复,但目前的文献仍然不清楚TBP后改善的长期可持续性.
研究的目的:
- 为了比较与健康相关的生活质量 (HRQOL) 和功能状况,在呼吸道支架形成后与TBP后进行比较.
- 通过评估手术后3个月和12个月的结果来评估TBP的持续疗效.
主要方法:
- 对120名患有严重呼气中心气道崩的患者进行了回顾性审查,这些患者接受了支架评估,随后进行了TBP (2004-2019).
- 基线,支架后和3个月和12个月的术后HRQOL分数 (例如,咳生活质量问卷) 和功能状态 (例如,6分钟步行测试,mMRC) 的分析.
主要成果:
- 与基线相比,在支架后评估中观察到生活质量和功能状态的显著改善.
- 这些改善从支架评估到TBP后的3个月和12个月都保持不变,在时间点之间没有发现显著差异.
- 预测的1秒强迫呼气量 (FEV1) 在整个研究期间没有出现临床上显著的变化.
结论:
- 在支架评估期间获得的生活质量和功能状况的改善可以预测TBP后长达一年的持续积极结果.
- 气道支架是评估TBP候选人的潜在手术成功的一个有价值的工具.
相关概念视频
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
22
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
22
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
21
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
21
01:24Endotracheal Tube Extubation
902
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....
902
01:16Tracheostomy Care I: Pre-procedural Steps
245
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
245
01:26Tracheostomy Suctioning I: Pre-Procedural Steps
692
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
692
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16