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在结直肠外科手术后,与ERAS协议一起使用防治性坦苏洛辛是否会改善?
Kamil Erozkan1, Mikhael Belkovsky1, Michael Klingler1
1Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
American journal of surgery
|December 5, 2024
概括
在手术后复原 (ERAS) 协议中,术后使用松素显著降低了结直肠手术后的尿和住院时间. 这一发现支持tamsulosin作为ERAS途径的一个有价值的补充,以改善患者的康复.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 麻醉学 麻醉学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 手术后增强康复 (ERAS) 协议旨在通过提前切除尿道导管来加快患者的康复和降低感染率.
- 然而,早期取出导管可能会导致尿,可能需要重新插入导管并延长住院时间.
- 已知坦苏洛辛是一种α阻断剂,可以有效地治疗男性和女性的尿.
研究的目的:
- 为了比较尿的发生率和相关的短期结果在接受选择性腹腔皮大肠直肠手术的患者.
- 为了评估术后松素在缓解ERAS途径内的尿留的疗效.
主要方法:
- 一项回顾性队列研究,涉及2072名根据ERAS协议 (2020年9月 - 2023年10月) 接受选择性腹腔皮层结直肠手术的患者.
- 从2022年4月开始接受术后坦苏洛辛 (0.4毫克) 的患者与对照组进行了比较.
- 倾向性得分匹配 (2:1比) 用于确保tamsulosin和对照组之间的可比性.
主要成果:
- 该研究包括2072名患者;倾向性得分匹配导致tamsulosin组的344名患者和对照组的688名患者.
- 用tamsulosin治疗的患者表现出明显较低的尿留率 (4.7%与9.2%,p=0.01).
- 接受tamsulosin的患者的住院时间也显著缩短 (4.2天与5天相比,p<0.01).
结论:
- 术后预防性坦苏洛辛的使用有效地降低了结直肠手术后的尿率.
- 坦素的使用与住院时间的缩短有关,有助于改善患者的康复.
- 坦素应该被认为是ERAS协议的宝贵补充剂,以提高恢复结果.
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