努力检测大动脉动脉瘤和人力资源培训,以优化他们的治疗
Carlos A Hinojosa-Becerril1, Javier E Anaya-Ayala1, Luis Bobadilla-Rosado1
1Dirección de Cirugía, Sección de Angiología, Cirugía Vascular y Terapia Endovascular, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
Cirugia y cirujanos
|September 7, 2023
概括
腹腔大动脉动脉瘤 (AAA) 仍然是一个重大问题,死亡率很高. 通过查计划进行早期检测对于减少并发症和改善患者结果至关重要.
科学领域:
- 血管外科 血管外科
- 公共卫生 公共卫生
- 医学教育 医学教育
背景情况:
- 腹腔大动脉动脉瘤 (AAA) 是导致发病和死亡的重要原因之一.
- 及时诊断和干预对于改善患者的治疗结果至关重要.
- 机构培训计划和选计划对AAA管理的影响需要评估.
研究的目的:
- 审查与AAA相关的入院,干预和住院死亡率.
- 分析在该机构实施AAA培训计划和成像查对AAA的影响.
主要方法:
- 从2010年到2020年,对国家数据库 (ND) 和机构记录 (INCMNSZ) 的回顾性分析.
- 包括住院数据,手术程序 (开放式修复与内血管排除 - EVAR) 和住院死亡率.
- 机构数据与国家趋势的统计比较和死亡率的评估.
主要成果:
- 总共有899个AAA住院病例记录在ND,其中85个在INCMNSZ.
- 在82%的病例中进行了开放式手术修复,而在18%的病例中使用了EVAR,INCMNSZ的频率更高 (p = 0.007).
- 30天住院死亡率为22.5%,ND (23.9%) 和INCMNSZ (16.4%) (p = 0.1) 之间没有显著差异.
结论:
- 在全国范围内,腹腔大动脉动脉瘤往往被诊断不足.
- 大学培训计划和成像查可以提高AAA早期检测.
- 这些举措有可能减少与紧急AAA程序相关的发病率和死亡率.
相关概念视频
01:26Aneurysm III: Interprofessional Care
9
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
9
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
01:22Aneurysm 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
01:25Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
01:17Aortic Regurgitation IV: Nursing Management
30
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
30
01:15Aortic Regurgitation I: Introduction
10
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
10