带尿转移的囊切除术后的呼吸道并发症:可避免的并发症还是不可避免的命运?
Silvia Martinez Carrique1, François Crettenand1, Kevin Stritt1
1Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
Journal of clinical medicine
|March 28, 2024
概括
术后呼吸道并发症 (PRC) 经过囊切除与尿路转移 (CUD) 手术后经常发生. 对手术后增强恢复 (ERAS) 协议的不良遵守增加了风险,导致住院时间更长和死亡率更高.
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
- 临界护理医学 临界护理医学
背景情况:
- 带尿路转移的囊切除术 (CUD) 是一种具有显著发病率的大型手术.
- 术后呼吸道并发症 (PRC) 是常见的,尽管手术后恢复 (ERAS) 协议.
研究的目的:
- 在CUD之后确定PRC的风险因素.
- 分析PRC对患者治疗结果的影响.
主要方法:
- 在2012-2022年间,对242名接受CUD治疗的患者进行了回顾性分析.
- 使用了奇平方,曼-惠特尼U测试和多变量考克斯回归.
- 包括PRC的分析,如肺炎,肺栓塞和呼吸衰竭.
主要成果:
- PRC发生在17%的患者中,与更长的住院时间和增加的30天死亡率有关.
- 对中国来说,不良的ERAS合规是显著的风险因素.
- 肺炎与手术后脏相关;肺栓塞与传染病/心血管并发症相关.
结论:
- 在CUD后,PRC显著恶化了结局,增加了住院和死亡率.
- 严格遵守ERAS协议对于中国预防至关重要.
- 关键的ERAS组件包括早期动员,呼吸物理治疗和避免鼻胃管.
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