在结肠镜检查过程中存在依赖持续时间的低血风险
Eyal Klang1, Kassem Sharif2, Offir Ukashi2
1Division of Data-Driven and Digital Medicine (D3M), Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Journal of clinical medicine
|July 13, 2024
概括
较长的结肠镜检查程序增加了严重低氧血的风险,氧和的危险下降. 优化手术长度和镇静是改善患者在这个常见的胃肠道检查期间安全的关键.
科学领域:
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
- 患者安全 患者安全
背景情况:
- 结肠镜是胃肠病学中至关重要的诊断和治疗工具.
- 严重的低氧化 (氧和率<90%) 是结肠镜检查期间的重大风险,影响患者的安全.
- 了解导致低氧血症的因素,如手术持续时间,对于降低风险至关重要.
研究的目的:
- 调查结肠镜检查过程的持续时间与严重低氧化血的发生率之间的关联.
- 确定结肠镜检查的特定时间值,与低血风险增加相关.
主要方法:
- 从2020年1月到2024年1月进行结肠镜检查的21524名成年患者的回顾性队列研究.
- 从电子健康记录中收集的数据,包括人口统计数据,镇静细节 (芬太尼,米达佐拉姆,普罗波) 和手术持续时间.
- 使用后勤回归分析来评估手术长度与严重低氧化血症之间的关系,并对混因素进行调整.
主要成果:
- 更长的结肠镜持续时间与严重低氧化血的风险更高显著相关.
- 低血的几率随着手术时间的增加而逐渐增加:20-40分钟 (aOR 1.5),40-60分钟 (aOR 2.1),>60分钟 (aOR 2.4).
- 年龄较大的患者 (60-80岁和≥80岁) 也表现出低氧化血的几率增加.
结论:
- 结肠镜手术的持续时间是一个关键的,可修改的因素,影响严重低氧化血的风险.
- 优化程序效率和定制镇静策略对于提高患者安全至关重要.
- 进一步的研究应侧重于减少结肠镜检查时间的策略,而不会影响诊断质量.
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