选择性腹腔镜结直肠切除术后的外科高依赖性入院:这是真的必要吗?
Jarrod K H Tan1, Wei-Ling Koh2, Cherie Hui Peh2
1Department of Surgery, National University Hospital, Singapore.
Journal of intensive care medicine
|August 16, 2023
概括
腹腔镜切除术患者的外科高依赖性 (SHD) 入院显示出与普通病房 (GW) 护理相似的结果. 这表明,通过重新评估SHD入院标准,可以优化重症监护的资源使用.
科学领域:
- 外科手术 手术手术
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 外科高度依赖 (SHD) 为手术患者提供一般病房 (GW) 和重症监护室 (ICU) 之间的中间护理.
- 没有普遍的SHD入学标准存在,导致潜在的资源浪费和减少重症监护能力.
- 本研究检查了选择性腹腔镜切除术后SHD入院的有效性.
研究的目的:
- 评估SHD入院对接受选择性腹腔镜切除术的患者的实用性.
- 为了比较接受SHD和GW的患者之间的术后结果和干预措施.
- 为 SHD. 优化录取标准的开发提供信息.
主要方法:
- 在2019年1月至2021年12月期间,对393名接受选择性腹腔镜切除术的患者进行了回顾性审查.
- 排除转换为开放性手术或需要术后ICU入院的患者.
- 在SHD和GW组之间对外术期间的参数和结果的比较.
主要成果:
- 153名患者 (38.93%) 需要SHD入院.
- 在SHD患者中,ASA得分,BMI,年龄和手术期间的血液损失都较高.
- 术后发病率和干预措施在SHD和GW组之间是相似的;没有SHD患者需要内托普或呼吸系统支持.
结论:
- 一般病房的患者通常更健康,但经历了与SHD患者相似的术后发病率和干预需求.
- 治疗延迟,缺乏持续监测,以及GW中护士对患者的比例较低,可能会影响具有有限生理储备的患者.
- 需要对高风险手术患者的安全性和成本效益进行进一步的研究,以持续远程监测生命体征.
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