胃肠道手术,恶性吸收条件,以及部手术后的术后低血症
Jesse E Passman1, Sara Ginzberg2, Julia A Gasior3
1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
以前经过前肠或中肠手术的患者在甲状腺和副甲状腺手术后面临低血的风险增加. 这种风险在全甲状腺切除术后特别高,特别是晚期出现的低血症.
科学领域:
- 内分泌学 在内分泌学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 手术后的低血是甲状腺和副甲状腺手术后的常见并发症.
- 虽然胃绕道术增加了低血症的风险,但其他吸收不良状况的影响仍然不清楚.
研究的目的:
- 调查各种医疗和手术吸收不良状况与甲状腺和副甲状腺手术后低血症的发生率之间的联系.
主要方法:
- 一项回顾性队列研究分析了25400名从2004年到2022年接受甲状腺切除和/或副甲状腺切除手术的患者.
- 患者按手术 (前肠/中肠,后肠) 或医疗 (克罗恩氏症,乳病) 吸收不良的情况进行分类.
- 后勤回归评估了吸收不良和早期 (<7天) 或晚期 (7-365天) 术后低血症之间的关系.
主要成果:
- 4.0%的患者有先前存在的吸收不良状况;8.8%的患者有早期和18.3%的患者有晚期低血症.
- 胰腺切除术使低血症的几率翻了一番 (OR 2.27,P=.031).
- 前肠/中肠手术增加了全甲状腺切除术后的低血症风险 (OR 1.65,P=.002),特别是晚发性低血症 (OR 1.82,P<.001).
结论:
- 之前的前肠和中肠切除与术后低血症风险的增加有关.
- 这种关联在接受全甲状腺切除术的患者中最为明显,特别是晚期低血症患者.
- 后肠外科手术和医疗吸收不良没有显示出与低血症的显著关联.
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