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在炎症性肠病患者手术延迟的术后结果:一个多中心队列研究
Ellen de Bock1, Eline S Herman2, Vincent Meij2
1Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. E.deBock-3@umcutrecht.nl.
Updates in surgery
|May 28, 2024
概括
在COVID-19大流行期间,炎症性肠病 (IBD) 患者的手术延迟没有增加. 然而,手术指示和手术程序之间的较长间隔与更高的术后并发症风险相关.
科学领域:
- 胃肠病学和外科手术
- 流行病学 流行病学
- 医疗保健管理的管理
背景情况:
- 推迟炎症性肠病 (IBD) 的手术护理可能会加剧疾病的进展.
- 随着COVID-19的流行,及时的医疗干预,包括选择性手术,面临着挑战.
研究的目的:
- 评估COVID-19大流行期间IBD患者延迟手术程序对临床结果的影响.
- 确定与IBD患者手术后并发症相关的风险因素.
主要方法:
- 一个多中心的回顾性队列研究,将在COVID-19大流行期间 (2020年3月16日至2020年12月31日) 接受手术的IBD患者与大流行前队列进行比较.
- 主要终点:重大术后并发症的发生率. 二级终点:从手术指示到手术的时间,并通过多变量分析对并发症的风险因素.
主要成果:
- 在流行病和流行病前队列 (34天与33.5天) 之间,没有观察到手术指示和手术程序之间的中位时间间隔有显著差异.
- 多变量分析表明,手术指示和手术程序之间的较长间隔与术后并发症风险增加显著相关 (OR1.03,p=0.034).
- 之前的手术已经成为重大术后并发症的独立预测因素 (OR4.25,p=0.018).
结论:
- 虽然COVID-19大流行并没有对IBD患者造成显著的手术延迟,但在指示和手术之间延长的间隔增加了并发症风险.
- 维持IBD患者的外科手术至关重要,特别是在医疗资源稀缺的时期,以防止疾病的进展和不良结果.
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