术后贫血与选择性结直肠瘤手术后的长期不良术后结果有关,在手术后的增强恢复过程中
J Ripollés-Melchor1, A Abad-Motos2, M L Fuenmayor-Valera3
1Infanta Leonor University Hospital, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Madrid, Spain.
Revista espanola de anestesiologia y reanimacion
|February 20, 2025
概括
结直肠手术后的术后贫血显著影响长期生存率. 出院时贫血的患者在五年内面临的死亡风险要大得多,这强调了贫血管理的必要性.
科学领域:
- 在瘤学瘤学.
- 外科手术 手术手术
- 血液学 血液学 血液学
背景情况:
- 贫血是主要腹部手术中不良结果的已知危险因素.
- 非心脏手术后的贫血增加了术后死亡风险.
研究的目的:
- 为了确定术后贫血的发生率.
- 评估结直肠癌手术后的短期和长期生存率.
- 在手术后增强恢复 (ERAS) 计划中评估结果.
主要方法:
- 对680名接受选择性结肠直肠瘤手术的患者进行了回顾性队列研究.
- 从2013年至2017年,对ERAS途径中的患者进行分析.
- 使用卡普兰-梅尔和考克斯回归的生存分析,专注于出院时的贫血.
主要成果:
- 出院时的贫血与明显较低的5年整体存活率相关 (44%与53.9%相比).
- 在出院时,贫血患者的死亡风险增加了2.66倍 (HR 2.663,p < 0.001).
- 联合手术前,手术后的贫血和红细胞输血增加了死亡风险.
结论:
- 手术后贫血是结直肠癌手术后减少长期生存的关键预测因素.
- 术前贫血,术后贫血和输血的结合显著增加了5年死亡风险.
- 贫血管理对于改善ERAS途径内接受结直肠瘤手术的患者的治疗结果至关重要.
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