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吸烟对30天并发症的影响 网状和非网状脱落手术
Tara D Marczak, Mallika Anand, Yi Hsieh1
1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA.
Urogynecology (Philadelphia, Pa.)
|January 29, 2025
概括
吸烟增加了30天的术后并发症,如感染和经过微创性形缩修复后的再入院. 网格的使用没有改变这种关联,这表明网格增大可能是安全的吸烟者咨询.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 烟草吸烟是不良手术结果的已知危险因素,导致人们对网状植入物愈合的担忧.
- 关于吸烟对经过骨盆器官脱落修复的短期 (30天) 术后并发症的影响的数据有限,特别是关于网状网的使用.
研究的目的:
- 评估烟草吸烟与手术后30天感染,再入院和重新手术风险之间的关联.
- 为了确定网状网的使用是否会改变吸烟对这些并发症的影响,在微创性形脱落修复中.
主要方法:
- 使用美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 数据库 (2012-2022) 的回顾性队列研究.
- 包括接受最小侵入性角骨盆器官脱落修复的患者.
- 分析30天的术后结果,包括感染,意外再入院和重新手术,按吸烟状况和网状使用进行分层.
主要成果:
- 吸烟者 (67,235名患者中的8.2%) 患术后感染和无计划再入院的风险显著增加.
- 在吸烟者中没有观察到意外重新手术的风险增加.
- 吸烟对30天并发症的影响不管是否使用手术网,都是一致的 (P-相互作用≥0.24).
结论:
- 烟草使用与经过微侵袭性形缩修复后30天术后并发症的小但显著增加有关.
- 网格增大似乎不会加剧与吸烟相关的风险,这表明在吸烟者中可能考虑使用它.
- 关于戒烟的适当的患者咨询对于优化手术结果至关重要.
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