相关实验视频
Updated: Jul 15, 2025

08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
16.5K
机械肠道制剂在选择性直肠直肠手术中不支持:一项回顾性研究
Greta Leitz-Najarian1, Melissa Najarian2
1University of North Carolina, Chapel Hill, NC, USA.
The American surgeon
|September 30, 2023
概括
在选择性结直肠手术中,常规的机械肠道制备 (MBPs) 不能显著降低伤口感染或道泄漏率. 它们的使用可能会增加尿路感染 (UTI),这项研究不支持.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 患者安全 患者安全
背景情况:
- 自20世纪70年代以来,机械肠道制备 (MBPs) 已成为结直肠外科手术的标准实践.
- 最近的证据质疑MBP的有效性和安全性,促使人们重新评估其作用.
- 有或没有肠道制剂的患者的并发症率需要进一步调查.
研究的目的:
- 在选择性结直肠手术中分析与各种肠道制备方法相关的风险和益处.
- 为了比较接受选择性结肠直肠手术的患者与不同肠道准备协议之间的并发症率.
- 为了确定机械肠道准备是否仍然是标准的护理.
主要方法:
- 在2008年至2021年期间进行的1237次选择性结直肠手术的回顾性病例审查.
- 患者根据肠道准备情况进行分类:机械肠道准备 (MBP),机械肠道准备与口服抗生素 (OAMBP),单独口服抗生素 (OA) 或没有肠道准备.
- 分析了包括伤口感染,静脉泄漏和尿路感染在内的结果,控制了并发症和阴囊使用.
主要成果:
- 结合的MBP和OAMBP组 (436名患者) 与没有准备 (636名患者) 或OA (165名患者) 相比,伤口感染或道泄漏没有显著差异.
- 在接受任何肠道制剂的患者中,尿路感染 (UTI) 发生的频率明显高 (P = .047).
- 在30天后的并发症,再入院,败血症,肺炎或逗留时间等其他结果中没有发现显著差异.
结论:
- 目前的数据不支持在选择性结直肠手术中常规使用机械肠道制剂.
- 结直肠外科手术中肠道准备的护理标准需要重新评估.
- 可以考虑采用替代策略或不进行肠道准备,以优化患者的治疗结果,并减少尿路感染等并发症.
相关概念视频
Inflammatory Bowel Disease V: Surgical Management
164
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
164
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
106
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
106
Endoscopic Procedures II: Colonoscopy
125
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
125
Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
102
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
102
Assessment of the Rectum and Anus
262
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
262

