克罗恩病选择性切除术的肠道准备:使用NSQIP数据库进行全球队列研究的结果
Gustavo Yano Callado1, Rodrigo Moisés de Almeida Leite1,2, Sergio Eduardo Alonso Araujo3
1Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo City, São Paulo, Brazil.
概括
结合机械和抗生素的肠道制备方法显著减少了在科伦氏病患者进行集体切除术时出现的解肠泄漏和深部器官感染. 这种方法也降低了口术率和住院时间.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 手术结果研究研究.
背景情况:
- 在克罗恩氏病患者的胆管切除术前进行肠道准备的必要性受到争议.
- 最佳的手术准备影响患者的治疗结果和并发症率.
研究的目的:
- 评估机械和抗生素肠道制备的临床结果与克罗恩病患者接受选择性切除术的没有准备.
- 确定肠道准备和关键手术并发症之间的关联.
主要方法:
- 来自美国外科医生学院国家外科质量改进计划 (2016-2021) 的潜在队列的回顾性分析.
- 包括6244名克罗恩氏病患者接受选择性切除术,分为准备和未准备的组.
- 主要结局:解剖管泄漏和深部器官感染;次要结局:死亡率,发病率,骨干,重新手术,手术时间,停留时间,骨髓.
主要成果:
- 结合肠道制备剂显著降低了解肠道泄漏 (RR 0.73) 和深部器官感染 (RR 0.68).
- 准备过的患者表现出较低的骨髓形成率,较短的住院时间,以及较低的骨髓发病率.
- 在短期死亡率或非计划性重新手术率方面没有观察到显著差异.
结论:
- 机械和抗生素肠道制备证明了对克罗恩氏病患者进行选择性切除术的临床益处.
- 肠道准备可能是优化这种患者群体手术结果的重要组成部分.
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