在微创性减肥手术后,术后出血的预测因素
Raul Sebastian1,2,3, Alba Zevallos4,5, Jorge Cornejo4
1Department of Surgery, Northwest Hospital, Randallstown, MD, USA. rsebast04@gmail.com.
Surgical endoscopy
|October 4, 2024
概括
手术前的抗凝药,功能不良,以及有DVT或PE病史,都会增加空腹手术后出血的风险. 这些因素一致预测了袖子胃切除术和胃绕道手术中的并发症.
科学领域:
- 腹部外科 腹部外科
- 最少侵入性的手术
- 外科手术的结果
背景情况:
- 最少侵入性的减肥手术 (袖子胃切除术和Roux-en-Y胃绕道) 提供有效的减肥,但会带来术后出血的风险.
- 手术后出血是一个重大问题,可能导致严重的发病率和死亡率.
研究的目的:
- 确定预测腹腔镜和机器人袖子胃切除术 (SG) 和Roux-en-Y胃绕道术 (RYGB) 后术后出血的关键因素.
主要方法:
- 来自MBSAQIP数据库 (2015-2021) 的大量患者队列的分析.
- 四个多变量逻辑回归模型被用于评估24个独立的因素,与腹腔镜SG (lapSG),机器人SG (rSG),腹腔镜RYGB (lapRYGB) 和机器人RYGB (rRYGB) 的术后出血相关.
主要成果:
- 抗凝治疗,功能不全,深静脉血栓塞 (DVT) 或肺栓塞 (PE) 的病史,以及体重指数 (BMI) ≤40都是跨手术出血的显著预测因素.
- 在机器人SG组中,COPD和高脂血症等特定因素是显著的,而心脏支架在RYGB组中是显著的.
结论:
- 手术前的抗凝药,功能不良,有DVT/PE病史,心脏支架存在,BMI ≤40都与术后出血风险增加有关.
- 已识别的出血预测因素在SG和RYGB的腹腔镜和机器人手术方法中是一致的.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
4
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
4
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
57
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...
57
Aneurysm IV: Nursing Management
3
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
3
Cardiomyopathy VII: Pre and Post Operative Nursing Management
3
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
3
Esophageal Varices-II: Clinical Features and Management
48
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
48
Peptic Ulcer Disease V: Surgical Management and Nursing Care
237
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
237


