风险因素向的外科手术期护理减少了结直肠手术后的解剖管泄漏:双检查研究
Anne de Wit1,2, Boukje T Bootsma1,2, Daitlin E Huisman1,2
1Department of Surgery, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Annals of surgery
|July 11, 2024
概括
通过增强护理包来最大限度地减少可修改的风险因素,在双检查研究中显著减少了结肠直肠道泄漏 (CAL). 这种干预改善了结直肠外科手术中的患者结果.
科学领域:
- 手术创新 在外科创新.
- 患者安全 患者安全
- 临床研究 临床研究
背景情况:
- 结肠直肠静脉泄漏 (CAL) 是一种严重的手术并发症.
- 在LekCheck研究中,确定了六种可修改的CAL手术内风险因素:贫血,高血糖,低温,抗生素时间,血管压缩剂使用和外周止痛.
研究的目的:
- 引入术前和术后的干预措施,旨在尽量减少对已识别的可修改风险因素的暴露.
- 确定这些干预措施对CAL的发生的影响.
主要方法:
- 从2021年9月到2023年12月进行的国际,开放标签的干预研究 (DoubleCheck).
- 实施一套增强的护理包,重点关注贫血纠正,血糖控制,正常热量,优化抗生素预防,避免血管压缩剂和外周止痛.
- 主要结果:手术内风险因素;次要结果:CAL和死亡率. 分析包括单变量和多变量回归.
主要成果:
- 双检查组 (902名患者) 的平均危险因子 (1.63) 与LekCheck组 (1572名患者,1.84) 相比较较少.
- 在双重检查组中,明显较少的患者具有≥3个风险因素 (P <0.001).
- 在双检查组 (6.2%对8.6%,P=0.039),与护理包相关的结肠直肠静脉泄漏 (CAL) 显着较低 (OR 1.521,P=0.045). 死亡率没有显著差异.
结论:
- 使用增强护理包优化可修改的风险因素,有效地减少了结直肠外科手术中的CAL.
- 双检查研究表明,它是改善患者安全和外科手术结果的成功策略.
更多相关视频
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
71
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...
71
Inflammatory Bowel Disease V: Surgical Management
139
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:
139
Peptic Ulcer Disease V: Surgical Management and Nursing Care
282
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
282


