在接受血管手术的肥胖患者中部并发症
Randall A Bloch1, Jacob L Neir1, Elisa Caron1
1Division of Vascular and Endovascular Surgery, St. Elizabeth's Medical Center, Boston University School of Medicine, Boston, MA.
Annals of vascular surgery
|September 29, 2024
概括
肥胖和女性患者在血管外科手术后经历更多的沟伤口并发症. 避免子皮质关闭并确保密切跟踪可以降低风险,特别是肥胖个体的轻微并发症.
科学领域:
- 血管外科 血管外科
- 手术部位感染 手术部位感染
- 患者的治疗结果.
背景情况:
- 在血管外科手术患者中,部切割伤口并发症 (WC) 很常见.
- 肥胖是已知的WC风险因素,但预防策略缺乏共识.
- 这项研究旨在确定肥胖患者的WC风险因素和预防方法.
研究的目的:
- 在肥胖的血管外科手术患者中确定部伤口并发症的特定危险因素.
- 评估在这个高危人群中预防伤口并发症的策略.
- 区分重大和轻微的伤口并发症.
主要方法:
- 对238个纵向沟切口 (2021-2022) 的回顾性审查.
- 患者分为肥胖 (BMI>30 kg/m2) 和非肥胖群体.
- 伤口并发症分为重大 (需要重新手术/再入院) 或轻微的.
主要成果:
- 肥胖显著增加了WC率 (39.1%对14.1%,P<0.001),主要是轻微的并发症.
- 女性性别也与较高的WC率 (27.6%对12.8%,P = 0.016) 相关.
- 在肥胖患者中,子皮质关闭与较轻微的WC相关 (OR 8.454,P = 0.044).
结论:
- 肥胖和女性性别是大腿伤口并发症的重要危险因素.
- 在肥胖患者中,皮肤底关闭可能会增加轻微的WC风险.
- 强化术后跟踪 (康复,家庭护理,频繁检查) 可以防止小 WC 升级.
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