术前化疗对大腹部手术后术后功能障碍的影响:一项前性观察性研究
Himanshu S Satapathy1, Lalit Sehgal2, Manoj Bhardwaj3
1Critical Care Medicine, Tata Main Hospital, Jamshedpur, IND.
Cureus
|August 9, 2024
概括
手术前的化疗会增加腹部癌症手术后急性损伤 (AKI) 的风险. 高尿蛋白与肌素的比率和血管压缩剂的使用也预测了AKI的发展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 在瘤学瘤学.
- 麻醉学 麻醉学
背景情况:
- 抗癌药物和主要的腹部手术独立地损害功能.
- 接受手术的癌症患者面临脏并发症的风险增加.
- 了解急性损伤 (AKI) 预测因子对于患者的治疗结果至关重要.
研究的目的:
- 确定在接受重大选择性腹部癌症手术的患者中术后AKI的发生率.
- 在接受手术前化疗的癌症患者中确定AKI的独立预测因子.
- 分析手术前化疗对AKI发展的影响.
主要方法:
- 对149名接受重大腹部癌症手术的成年患者进行前性观察性研究.
- 患者被分为两组:接受手术前化疗的患者和没有接受化疗的患者.
- 使用奇平方,曼-惠特尼U测试和多变量逻辑回归分析手术前和手术内因素的分析.
主要成果:
- 整体术后AKI发生率为24.2%,在手术前化疗组 (32.4%对16%) 显着更高.
- AKI的独立预测因素包括手术前化疗,高尿蛋白与肌素比率 (UPCR ≥0.345) 和手术内血管压缩剂的使用.
- 术前UPCR≥0.345显示高灵敏度 (77.8%) 和特异性 (83.2%) 预测AKI.
结论:
- 手术前的化疗是主要的腹部癌症手术后AKI的重要风险因素.
- 通过UPCR和血管压缩剂的使用来识别高风险患者可以帮助早期检测AKI.
- 基于已识别的预测因素的快速措施可能会改善患者的预后.
相关概念视频
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...