三十天的并发症,无计划的医院遭遇,和死亡率后内声学和/或指导支气管镜检查:一个前性研究
Daniele Magnini1, Giovanni Sotgiu2, Giuseppe Bello3
1Interventional Pulmonology Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
晚期支气管镜检查的严重并发症并不常见,但很严重,通常在手术后几天发生. 积极的监测对于在怀疑恶性瘤的患者中管理这些风险至关重要.
科学领域:
- 肺部病理学 肺部病理学
- 干预性肺病学 干预性肺病学
- 医疗成像医学成像
背景情况:
- 关于经过高级诊断支气管镜检查后出现的不良事件的数据有限.
- 现有的数据往往来自回顾性研究,重点关注早期并发症.
研究的目的:
- 为了前性地评估30天内声学和指导支气管镜检查后严重并发症的发病率和风险因素.
- 分析不良事件的时间,包括晚发症并发症.
主要方法:
- 一项为期15个月的前性队列研究,对在全身麻醉下接受内声学和/或导向支气管镜检查的患者进行.
- 评估严重并发症的30天发病率,任何并发症,意外住院和死亡.
- 分析并发症发病时间 (即时,早期,晚期) 和风险因素识别.
主要成果:
- 697名患者中有2.4%发生严重并发症; 47.1%的严重并发症和72.7%的非计划性住院发生在晚期 (手术后几天到几周).
- 两例死亡 (11.7%) 与严重并发症有关,观察到晚期发病.
- 在活检部位的低剂量CT减弱独立预测任何并发症,意外的医院遭遇和死亡率.
结论:
- 虽然不常见,但高级支气管镜检查的严重并发症具有显著的临床影响.
- 很大一部分不良事件是晚期出现的,这强调了积极主动的监测计划的必要性.
- 早期识别风险因素,如CT发现,可以帮助患者管理和预测结果.
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