"手术第一"与"内镜第一"对于儿科胆固醇结石病在本周末呈现 - - 一个CARES工作组研究研究
Garrett Reid1, Jessica L Rauh1, Elizabeth Wood1
1Wake Forest School of Medicine, Winston Salem, USA.
Journal of pediatric surgery
|October 6, 2024
概括
针对儿科胆固醇病的手术第一方法与内镜第一策略相比,显著减少了住院和治疗时间. 这种方法是有效的,无论患者的介绍时间,导致更少的程序和提高效率.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 肝胆道手术 肝胆道手术
背景情况:
- 儿童胆固醇病通常使用内镜-首先 (EF) 策略治疗,涉及ERCP和LC.
- 周末,ERCP的可用性可能会受到限制,这可能会延迟护理.
- 手术第一 (SF) 方法可能在治疗儿科胆固醇质症方面具有优势.
研究的目的:
- 为了比较SF与EF策略对儿科胆道胆病的疗效.
- 评估介绍时间 (工作周与周末) 对治疗结果的影响.
- 为了确定停留时间 (LOS) 和最终干预时间 (TTDI) 的差异.
主要方法:
- 儿科患者 (2018-2023) 怀疑患有胆固醇胆病的多中心,回顾性队列研究.
- 定义工作周 (WW) 为周一至周四的入学时间.
- TTDI计算为时间到LC或术后ERCP.
主要成果:
- 分析了354名患者,61%接受SF治疗,39%接受EF治疗.
- 与EF (88.5h WW, 93.6h EoW) 相比,SF与显著更短的LOS (60.2h WW, 58.3h EoW) 相关.
- SF显著降低了TTDI (26.4h WW, 28.9h EoW) 与EF (61.4h WW, 72.8h EoW) 相比.
- 大多数SF患者 (79%) 接受过一次手术,而所有EF患者至少接受过两次手术.
结论:
- 在一周末 (EoW) 呈现的儿科胆固醇病导致较长的LOS和TTDI,特别是在EF方法下.
- 首先进行手术的方法可以减少儿科胆固醇病的手术,TTDI和LOS.
- SF是一个更有效的策略,无论介绍时间如何.
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