在患有非封闭性介质缺血症的患者中,90天后术后死亡结果的术前风险因素
Makoto Uchino1, Daichi Kitaguchi2, Kinji Furuya1
1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Langenbeck's archives of surgery
|July 2, 2024
概括
手术前低碳酸盐和高乳酸盐水平预测非闭合性中肠缺血的90天死亡率. 需要血液透析的患者在手术后面临着独特的死亡风险.
科学领域:
- 胃肠病学 胃肠病学
- 手术重症监护手术重症监护
- 这是血管外科手术.
背景情况:
- 尽管进行了积极的治疗,但非封闭性介质缺血症 (NOMI) 的死亡率很高.
- 对于NOMI的紧急手术是复杂的,并与严重的术后挑战有关.
研究的目的:
- 在接受紧急手术的NOMI患者中确定90天死亡的术前风险因素.
- 分析导致NOMI幸存者晚期死亡的因素.
主要方法:
- 20名接受紧急手术的NOMI患者的回顾性队列研究 (2014年8月 - 2023年1月).
- 术前临床数据,实验室结果和90天随访后存活率和死亡率组之间的成像数据的比较.
主要成果:
- 50% (10/20) 的患者在手术后90天内死亡.
- 较低的手术前碳酸盐 (HCO3-) 和较高的乳酸盐水平与死亡率有显著的关联.
- 晚期死亡 (30天后) 往往与由于血液动力学不稳定的血液透析中止有关.
结论:
- 手术前低碳酸盐和高乳酸盐是NOMI中90天死亡的潜在风险因素.
- 血液透析依赖带来了特定的死亡风险,即使在急性NOMI管理后.
- 认真考虑手术指示对于NOMI患者具有已确定的风险因素至关重要.
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