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增强康复后糖尿病患者的术后结果 胸腔镜叶片切除术
Lin Huang1, René Horsleben Petersen1, Henrik Kehlet2
1Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Surgical endoscopy
|June 7, 2024
概括
增强的恢复途径 (ERAS) 可能会减轻糖尿病患者接受视频辅助胸腔镜手术 (VATS) 的风险. 虽然停留时间和并发症相似,但糖尿病患者的死亡率更高,可能是由于并发症.
科学领域:
- 胸部外科手术 胸部外科手术
- 内分泌学 在内分泌学.
- 外科手术的结果
背景情况:
- 糖尿病是已知的手术风险因素.
- 有限的数据存在于增强手术后康复 (ERAS) 协议中的糖尿病管理.
- ERAS途径旨在优化外科手术的结果.
研究的目的:
- 在ERAS设置中,评估糖尿病患者的术后结果,这些患者接受视频辅助胸腔镜手术 (VATS) 叶切除术.
- 在ERAS环境中比较糖尿病和非糖尿病患者之间的结果.
主要方法:
- 关于ERAS VATS脑叶切除术 (2012-2022) 的前数据库的回顾性分析.
- 包括3164名患者,其中323人被确定患有糖尿病.
- 结果指标包括停留时间 (LOS),再录取和死亡率.
主要成果:
- 糖尿病患者和非糖尿病患者之间在LOS,术后并发症或30天生存期没有显著差异.
- 糖尿病患者的30日和90日死亡率显着更高 (p < .001).
- 在糖尿病组中发现了较高的手术前并发症;HbA1c水平与结果无关.
结论:
- 在ERAS环境中,糖尿病似乎不会增加长期LOS,并发症或VATS叶切除术后再入院的风险.
- 糖尿病患者30日和90日死亡率的增加很可能归因于更大的手术前并发症.
- 埃拉斯协议可能为糖尿病患者的VATS叶切除术提供一个安全的环境,并仔细考虑并发症.
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