在接受腹部上部手术的患者中,术后肺部并发症:风险因素和预测模型
Shivam Garg1, Vishnukanth Govindaraj2, Dharm Prakash Dwivedi3
1Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry. shivjmv@gmail.com.
概括
手术前的胸部X射线,BUN水平和手术持续时间可以预测术后肺部并发症 (PPC). 美国麻醉学会 (ASA) 的得分比ARISCAT得分更好地预测PPC风险.
科学领域:
- 麻醉学和外科手术期间的医学.
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 手术后的肺部并发症 (PPCs) 对手术后的患者结果产生重大影响.
- 早期识别患有PPC风险的患者对于实施预防策略至关重要.
- 腹部上部手术具有显著的发展PPCs的风险.
研究的目的:
- 在接受腹部上部手术的患者中,确定术后肺部并发症 (PPC) 的风险因素和预测因素.
- 为了比较美国麻醉学会 (ASA) 评分,ARISCAT评分,6分钟步行测试 (6MWT) 和PPCs的螺旋计的预测准确度.
主要方法:
- 对133名接受选择性腹部上部手术的成年患者进行前性研究.
- 术前评估包括临床病史,螺旋计,6分钟步行测试 (6MWT),ASA分数和ARISCAT分数.
- 进行了手术后的随访,以根据EPCO指南识别和定义PPC.
主要成果:
- 27%的患者 (20.3%) 患有PPC,其中最常见的是肺溢液.
- 多变量分析确定了异常的胸部放射,血液尿素 (BUN) 和手术持续时间作为PPCs的独立预测因素.
- ASA得分显示,PPC的预测能力比ARISCAT得分更好,而6MWT和螺旋计没有显著的预测价值.
结论:
- 手术前的胸部放射,BUN水平和手术持续时间是与发展PPC相关的关键独立因素.
- ASA评分是比ARISCAT评分更有效的工具,可以在这个患者群体中分层分类PPC风险.
- 在接受腹部上部手术的患者中,常规的手术前螺旋计和6MWT可能对预测PPC没有临床有用性.
相关概念视频
01:30Pneumonia I: Introduction
233
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
233
01:30Pneumonia III: Complications and Assessment
206
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
206
01:27Pneumothorax-II
142
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
142
01:19Factors Affecting Pulmonary Ventilation
1.4K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.4K