视频辅助胸腔镜手术中的术后肺部并发症:我们的10年经验
Özlem Turhan1, Nükhet Sivrikoz1, Salih Duman2
1Department of Anesthesiology and Reanimation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye.
Turk gogus kalp damar cerrahisi dergisi
|March 28, 2024
概括
清醒视频辅助胸腔镜手术可以减少高风险患者的术后肺部并发症. 这项研究分析了使用ARISCAT风险评分的246名患者,发现风险组之间的并发症率相似.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 肺部医学 肺部医学
背景情况:
- 评估术后肺部并发症对于手术风险分层至关重要.
- 加泰罗尼亚外科手术患者呼吸风险评估 (ARISCAT) 评分有助于识别有风险的患者.
- 视频辅助胸腔镜手术 (VATS) 是一种正在发展中的微创手术技术.
研究的目的:
- 评估清醒VATS对术后肺部并发症的影响.
- 为了比较不同ARISCAT风险分数的患者的并发症率.
- 在不同患者风险类别中确定清醒VATS的安全性和有效性.
主要方法:
- 在2011年至2021年期间,246名患者接受了清醒VATS的回顾性分析.
- 根据ARISCAT得分将患者分为低/中等 (L组) 和高 (H组) 风险.
- 用米达佐拉姆/芬太尼,补充氧气和肋间神经阻塞进行镇痛的镇静.
主要成果:
- 在L组 (17%) 和H组 (27%) 之间肺部并发症没有统计学上显著的差异 (p=0.056).
- 与肺部切除手术相比,肺部切除手术的并发症发生率明显高 (p=0.027).
- 风险组的人口统计和操作数据在风险组中相似.
结论:
- 唤醒VATS可能有助于缓解术后肺部并发症,特别是在高危人群中.
- 亚里斯卡得分是对接受清醒VATS的患者进行风险评估的一个有价值的工具.
- 需要进一步的研究来证实这些发现,并优化患者的选择.
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