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在为卵巢癌进行高温腹腔内化学疗法后,是否需要例行入院至重症监护机构?
Ruby M van Stein1, S Lot Aronson2, Karolina Sikorska3
1Dept. of Gynecologic Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
概括
对于所有患者来说,对于卵巢癌的高温腹腔内化疗 (HIPEC) 后的常规重症监护入院可能不必. 一种新的预测模型可以识别低风险的个体,潜在地减少关键护理负担和成本.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
背景情况:
- 高热性腹膜内化学疗法 (HIPEC) 越来越多地用于第三阶段卵巢癌的间隔后细胞还原手术 (CRS).
- 在CRS-HIPEC之后,常规的术后重症监护入院的必要性仍然不确定.
研究的目的:
- 估计CRS-HIPEC后需要重症监护的发生率.
- 开发一个预测模型来识别可能不需要重症监护入院的患者.
主要方法:
- 对154名接受间隔CRS-HIPEC的卵巢癌患者的回顾性分析.
- 后勤回归和引导被用来开发和验证一个关键护理预测模型.
主要成果:
- 38%的患者接受了术后关键护理,主要是血液动力学干预.
- 关键护理的独立预测因素包括失血,北上腺素剂量和年龄 (AUC=0.76).
- 一个模型将三分之一的患者确定为低风险患者 (NPV=0.88在20%的概率截止值).
结论:
- 大多数患者,特别是那些手术复杂度较低的患者,在CRS-HIPEC后不需要重症监护.
- 选择性重症监护入院可能是可行的,需要进行前性评估.
- 开发的模型可以帮助选择患者省略重症监护,降低成本和重症监护单位的负担.
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