在切除肝脏后意外的外科手术期间低温和手术部位感染
Yi-De Zhou1, Wen-Yuan Zhang1, Guo-Hao Xie1
1Department of Anesthesiology and Intensive Care Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Hepatobiliary & pancreatic diseases international : HBPD INT
|January 7, 2024
概括
在切除肝脏的患者中,轻度的外科手术期间低温并没有显著增加手术部位感染 (SSI). 有效的温度管理可能会减轻低温症.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术感染 手术感染
- 热调节 热调节 热调节
背景情况:
- 在外科手术期间的低温与外科手术部位感染 (SSI) 的增加有关.
- 之前的临床试验对低温和SSI的关联产生了相互矛盾的结果.
- 在切除肝脏后,外科手术期间的低温和SSI之间的特定关系需要进一步调查.
研究的目的:
- 调查意外外科手术期间低温和手术部位感染 (SSI) 之间的相关性.
- 评估低温症作为术后并发症的独立风险因素,肝切除后.
主要方法:
- 肝切除患者的回顾性队列研究 (2019年1月至2021年12月).
- 倾向性得分匹配 (PSM) 以平衡常温和低温组.
- 单变量和多变量回归分析,以评估低温对SSI和并发症的影响.
主要成果:
- 在PSM之后,低温 (7.0%) 和正常热量 (6.3%) 组之间SSI发生率没有显著差异 (P=0.453).
- 低温并不是SSI,术后输血或重大并发症的独立风险因素.
- 低温组显示肝功能测试的改变 (较低的GGT,ALP) 和延长的aPTT.
结论:
- 在切除肝脏的患者中,轻度的外科手术期低温与SSI风险增加无关.
- 有效的术后温度管理,包括主动加热,可能会减轻低温的潜在影响.
- 需要进一步的研究,以了解温度调节与肝脏手术结果之间的细微关系.
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