在疫苗前时代进行腹腔镜胆囊切除术/尾切除术的COVID-19患者的结果
Steven K M Vuu1,2, Huazhi Liu2, Darwin N Ang1,3,2
1University of Central Florida College of Medicine, United States.
Surgery in practice and science
|January 23, 2025
概括
在COVID-19患者进行腹腔镜胆囊切除术 (腹腔镜胆囊切除术) 面临着显著更高的住院患者死亡率和ARDS风险在疫情的最初浪潮. 腹腔镜尾切除术 (腹腔镜尾切除术) 没有显示增加风险.
科学领域:
- 一般外科 整体外科
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 最初的COVID-19大流行浪潮为手术患者管理带来了独特的挑战.
- 了解外科手术对COVID-19患者结果的影响对于临床决策至关重要.
研究的目的:
- 为了调查经过腹腔镜胆囊切除术 (腹腔镜胆囊切除术) 或腹腔镜尾切除术 (腹腔镜尾切除术) 的COVID-19患者的住院死亡率.
- 为了比较经过手术和没有手术的COVID-19患者之间的结果.
主要方法:
- 从2020年1月1日至2020年9月30日期间,对82574名COVID-19患者进行了回顾性队列分析.
- 在手术 (腹腔胆固醇,N=323;腹腔,N=106) 和非手术 (N=82,145) COVID-19 患者之间比较住院患者的死亡率和并发症率 (ARDS,肺炎,DVT,PE,UTI,MI,RF).
主要成果:
- 住院患者的死亡率在接受膝盖胆固醇 (32.8%) 的COVID-19患者中明显高于膝盖手术 (2.8%) 和非手术对照 (1.2%) 的患者.
- 急性呼吸困扰综合征 (ARDS) 并发症发生率在膝盖胆固醇组 (11.2%) 与膝盖膜 (1.9%) 和对照组 (0.2%) 显著增加.
- 与对照组相比,腹腔镜尾切除并没有显示出死亡率或ARDS的显著增加.
结论:
- 在最初的流行病浪潮期间接受腹腔镜胆囊切除术的COVID-19患者经历了显著增加的死亡率和ARDS风险.
- 在COVID-19阳性患者的腹腔镜尾切除似乎与死亡率或ARDS风险的增加无关.
- 这些发现强调了手术程序对COVID-19患者结果的差异性影响.
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