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患者和程序因素对中腹腔绕道术后结果的影响
William P Zickler1, Benjamin R Zambetti2, Christine L Zickler3
1Department of Surgery, Mount Sinai Hospital, New York, NY, USA.
The American surgeon
|September 1, 2023
概括
对于缺血的中腹腔绕道有很高的发病率和死亡率. 手术前的败血症预测心血管问题,而高的INR或慢性心力衰竭预测肺部并发症.
科学领域:
- 血管外科 血管外科
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 介肠旁路 (MB) 是一种治疗急性 (AMI) 和慢性介肠缺血症 (CMI) 的方法.
- MB与显著的心血管和肺部并发症有关.
研究的目的:
- 确定心血管 (CV) 和肺部发病率的独立预测因子,在接受AMI和CMI的MB患者中.
- 分析影响结果的患者和程序因素.
主要方法:
- 从2008年到2019年接受MB的377名AMI和CMI患者的回顾性审查.
- 多变量逻辑回归 (MLR) 用于识别心血管和肺部疾病的预测因素.
主要成果:
- 患有AMI的患者手术前败血症的发病率较高,需要更多的肠切除,术后败血症和死亡率增加.
- MLR确定了手术前的败血症作为心血管发病率的独立预测因素 (OR 1.96).
- 国际正常化比率 (INR) 升高 (OR 3.16) 和慢性心力衰竭 (CHF) (OR 5.88) 是肺部发病率的独立预测因素.
结论:
- 间肠道旁路治疗间肠道缺血与高发病率和高死亡率有关,无论是急性还是慢性.
- 术前败血症预测心血管发病率,无论缺血症类型或绕道配置如何.
- 升高的INR和潜在的CHF增加了MB后肺部并发症的风险.
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