在头部和部的手术后尿道并发症自由重建手术
Kimberly Chan1, Allison Keane2, Sandeep Pradhan3
1Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
The Annals of otology, rhinology, and laryngology
|October 30, 2023
概括
福利导管的持续时间影响了头部和部自由手术后的术后尿路保留风险. 在21至48小时之间切除导管可能会减少并发症,但不会增加感染率.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 整形外科 整形外科 整形外科
背景情况:
- 接受自由重建的头癌患者面临手术后尿道并发症的风险.
- 手术后的尿 (POUR) 和导管相关的尿路感染 (CAUTI) 是潜在的不良事件.
- 优化福利导管管理对于这一群体患者的康复至关重要.
研究的目的:
- 为了评估手术后的尿道并发症在接受头部和部自由手术的患者.
- 为了确定这些程序后福利导管切除的最佳时间.
- 确定与POUR和CAUTI相关的风险因素.
主要方法:
- 一项回顾性病例控制研究包括211名患者,他们接受了针对头部和部病理的自由重建.
- 对POUR患者风险因素的分析,包括福利导管的持续时间,液体体积和BMI.
- 统计测试 (费舍尔精确,威尔科克森排名总和) 用于评估并发症率和风险因素.
主要成果:
- 高龄,较低的BMI,较低的手术内液体体积和需要直径导管是需要福利置换的POUR显著风险因素.
- 较短的总和术后福利持续时间与需要直导管的POUR风险增加有关.
- 大约60%需要直径导管的患者需要福利替代;只有1名患者 (0.5%) 患有尿路感染.
结论:
- 福利导管的持续时间是影响POUR和随后的福利替换风险的关键因素.
- 福利导管切除的最佳时间需要进一步调查.
- 在手术后21至48小时内取出导管可以减轻POUR风险,而不会增加CAUTI的发生率.
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