在没有手术咨询的情况下,不要让太阳在小肠阻塞上升-重新定义非手术管理途径
Umar F Bhatti1, Aricia S Shen1, Nicolas Melo1
1Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.
The American surgeon
|April 21, 2024
概括
对小肠阻塞 (SBO) 实施早期手术咨询,通过增加手术咨询和小肠随访 (SBFT) 使用,改善了患者的护理. 这项干预措施显示了减少再入院和降低SBO患者成本的趋势.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 医疗保健管理的管理
背景情况:
- 小肠阻塞 (SBO) 是常见的住院原因,通常非手术治疗 (NOM).
- 非手术治疗可能导致长时间住院,再入院和增加资源使用.
- 早期的外科咨询 (SC) 可以提高SBO病例的效率和患者的结果.
研究的目的:
- 评估促进SBO患者早期SC (<1天) 的全机构干预 (INT) 的影响.
- 为了评估SC率的变化,小肠后续治疗 (SBFT) 的利用,停留时间 (LOS),再录取和成本.
主要方法:
- 对从2021年1月到2023年6月需要NOM的SBO患者的回顾性分析.
- 根据2022年7月实施的干预措施,患者被划分为干预前 (pre-INT) 和干预后 (post-INT) 组.
- 关键结果包括SC率,早期SC,SBFT利用率,LOS,30天再录取率和录取成本.
主要成果:
- 后INT组显示显著更高的SC率 (94.0%vs83.3%) 和增加的SBFT利用率 (47.0%vs33.6%).
- 早期SC (<1天) 在后INT组显著改善 (74.3%vs65.7%).
- 没有观察到LOS的显著差异;然而,在后INT组中发现了30天再接收减少的趋势 (7.3%对11.0%) 和更低的直接成本.
结论:
- 机构范围内的干预措施有效地增加了SBO患者的早期手术参与.
- 这项干预导致了SC率的提高和SBFT利用率的增加.
- 早期的外科咨询表明,SBO管理的再入院和医疗费用减少的积极趋势.
相关概念视频
Inflammatory Bowel Disease V: Surgical Management
145
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
145
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
79
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
79
Peptic Ulcer Disease V: Surgical Management and Nursing Care
299
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
299
Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80


