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手术前慢性病和胰腺切除术后的并发症:一个回顾性队列研究
Oskar Swartling1,2, Marie Evans3, Patrik Larsson2,4
1Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
ANZ journal of surgery
|September 1, 2023
概括
患有慢性病且接受胰腺切除术的患者面临更高的长时间住院和体重增加的风险. 术前功能评估对于这些患者的手术风险分层至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 慢性病 (CKD) 在手术患者中很常见.
- 它对胰腺切除术后的结果的影响还不清楚.
- 这项研究调查了CKD与该患者组并发症的关联.
研究的目的:
- 为了评估经手术后并发症的风险,脏功能减弱的患者接受胰腺二切除术.
- 评估手术前估计的膜过率 (eGFR) 与手术结果之间的关联.
- 确定功能评估对风险分层的重要性.
主要方法:
- 对971名接受胰腺二切除术 (2008-2019) 的患者进行了回顾性分析.
- 慢性病定义为手术前的eGFR<60毫升/分钟/1.73m2.2.
- 对标准化术后并发症进行的后勤回归分析.
主要成果:
- 10%的患者患有CKD (eGFR<60毫升/分钟/1.73米2).
- 慢性病与更长时间住院的可能性增加 (aOR 1.58) 和术后体重增加 (aOR 2.02).
- 较高的eGFR与更低的ICU入院几率,延迟的胃排空和胰腺结有关.
结论:
- 手术前脏功能下降增加了手术后严重并发症的可能性和胰腺切除术后体重增加.
- 术前功能评估对于准确的风险分层至关重要.
- 优化功能可能会改善手术结果.
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