全国对血管外科住院医生在外围动脉疾病中的手术经验进行分析
Christina L Cui1, Roberto S Loanzon1, Kevin W Southerland1
1Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Medical Center, Durham, NC.
Journal of vascular surgery
|August 9, 2023
概括
血管外科住院医生正在进行更多的外周动脉疾病 (PAD) 手术,开放式和内血管手术的数量显著增加. 这一趋势凸显了培训需求的不断变化,尽管微创技术的兴起.
科学领域:
- 血管外科 血管外科
- 医学教育 医学教育
- 周围动脉疾病 (PAD) 周围动脉疾病
背景情况:
- 对PAD的内血管和混合干预的使用越来越多,这引发了人们对开放外科培训充足性的担忧.
- 最近的试验强调了对关键四肢缺血的开放手术技术的重要性.
- 需要评估综合血管外科住院医生的外围手术体积的国家趋势.
研究的目的:
- 检查综合血管外科住院医生中外围手术病例数量的国家时间趋势.
主要方法:
- 美国医学研究生认证委员会 (Utilized Accreditation Council for Graduate Medical Education) 针对综合血管外科住院医生的国家数据报告.
- 从2012-2013学年和2021-2022学年收集的病例数量 (外科医生首席或初级).
- 使用线性回归分析案例组合和体积的趋势.
主要成果:
- 总体而言,血管手术体积增加,外围病例最常见,年增长最大.
- 开放的外周绕道和股骨关节手术没有显示出显著的体积变化.
- 血管内外周围血管再循环化 (心脉,骨,,) 和下肢截肢的体积显著增加.
结论:
- 毕业的居民在全国范围内表现出更高的开放和内血管外周动脉疾病病例数量.
- 观察到的趋势需要进一步研究对血管外科的里程碑和培训的影响.
- 趋势可能会影响对基于能力的培训计划日益增长的兴趣.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Peripheral Artery Disease III: Interprofessional Care
11
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
17
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
17
Peripheral Artery Disease IV: Nursing Management
12
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
12
Peripheral Artery Disease I: Introduction
9
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
9
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8


