[选择手术方法和在广泛的腹膜炎中完成腹腔切除术的选择]
N V Lebedev1, A E Klimov1, V S Shadrina1
1Peoples' Friendship University of Russia, Moscow, Russia.
Khirurgiia
|November 2, 2023
概括
一个新的系统有助于对晚期腹膜炎的手术决定,结合临床和视觉数据来预测结果. 这种方法旨在改善复杂腹膜炎病例的手术策略和患者的治疗结果.
科学领域:
- 手术方面的创新.
- 膜炎的管理管理
- 临床决策支持系统临床决策支持系统
背景情况:
- 先进的二次腹膜炎带来了复杂的外科手术挑战.
- 选择手术方法和完成腹腔切除术的现有方法可能缺乏全面的预测能力.
- 系统性评估对于优化腹膜炎治疗策略至关重要.
研究的目的:
- 开发一种新的系统,用于选择手术方法和完成腹腔切除术在先进的二次腹膜炎.
- 将临床,视觉腹内标准和结果预测系统整合到一个连贯的决策工具中.
- 通过结构化的方法,加强广泛的腹膜炎的管理.
主要方法:
- 一项对686名腹膜炎患者 (2015年5月至2022年12月) 的回顾性研究.
- 包括临床数据,腹腔内发现和手术完成方法 (腹腔镜检查,初级腹腔镜检查,闭门腹腔镜检查,分阶段手术,开腹,重复腹腔镜检查).
- 分析与不同外科手术方法和完成技术相关的死亡率和原因.
主要成果:
- 在二次腹膜炎中开发的手术方法和完成指数对于决策非常有价值.
- 在70.1%的患者中进行了诊断性腹腔镜检查,在62.8%的患者中进行了成功的腹腔镜手术.
- 总体死亡率为15.0%,败血症/败血性休克是主要原因 (65.0%).
结论:
- 综合评估系统是有效的系统化结果和评估治疗结果在周围炎.
- 开发的系统有助于选择广泛的腹膜炎的最佳手术接入和完成策略.
- 进一步研究和应用这些综合系统可以改善腹膜炎的管理和患者的治疗结果.
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