细胞还原性手术与高温腹腔内化疗对功能的副作用
Diego Beltrán1, María-Consuelo Pintado1,2, Ana Oñoro1
1Intensive Care Unit. Hospital Universitario Príncipe de Asturias. 28805 Alcalá de Henares, Madrid, Spain.
International journal of medical sciences
|October 23, 2024
概括
急性损伤 (AKI) 的发病率在接受细胞削减手术和高温腹腔内化疗 (HIPEC) 的患者中较低. 电解质失衡是常见的,但AKI并没有增加死亡率.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术重症监护手术重症监护
背景情况:
- 细胞还原性手术 (CRS) 与高热性腹腔内化疗 (HIPEC) 构成由于腹腔内压力,热应激和药物毒性的急性损伤 (AKI) 的风险.
- 在接受这些复杂的手术的患者中,AKI是一个重大问题.
研究的目的:
- 在CRS和HIPEC后的患者中调查AKI的发病率和风险因素.
- 评估该患者群体中AKI和死亡率之间的关联.
主要方法:
- 在129个月的时间里,对123名在CRS和HIPEC后进入ICU的患者进行了回顾性分析.
- 收集的数据包括人口统计,疾病严重程度 (SOFA分数),实验室结果 (功能,电解质),癌症类型,HIPEC细节,液体平衡和结果 (ICU/住院,死亡率).
主要成果:
- AKI的发病率很低,为4.9%.
- AKI的危险因素包括卵巢癌,多克索鲁比使用,阳性液体平衡,较高的SOFA分数和机械通风.
- 电解质障碍 (低血症,低血症) 非常普遍 (95.8%),但AKI与死亡率增加无关.
结论:
- 该研究发现,在CRS和HIPEC后,AKI的发病率较低,电解质干扰很常见.
- 诸如癌症类型 (非米托米辛治疗方案) 和手术期间的正流体平衡等因素可能会增加AKI风险.
- 尽管AKI患者的临床状况较差,但死亡率与非AKI患者相似.
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