早期遵守增强恢复协议作为肝脏手术后并发症的预测因素
Cristina Ciulli1, Alessandro Fogliati2,3, Andrea Scacchi3
1HPB Surgery Unit, Department of General Surgery, IRCCS San Gerardo dei Tintori Foundation, Via Pergolesi 33, 20900, Monza, Italy. cristinamarialuisa.ciulli@irccs-sangerardo.it.
Updates in surgery
|March 15, 2025
概括
在肝脏手术中早期不遵守增强恢复协议 (ERP) 会显著增加患者的发病率. 遵守术后ERP指南对于减少并发症和改善肝脏手术后的结果至关重要.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术结果研究研究.
- 患者恢复协议 患者恢复协议
背景情况:
- 增强恢复协议 (ERP) 旨在尽量减少住院时间,加快患者手术后的恢复.
- 肝脏手术患者经常面临长时间住院和更慢的恢复到基线健康.
- 调查遵守ERP元素及其对肝脏手术并发症的影响至关重要.
研究的目的:
- 确定早期不遵守术后增强恢复协议 (ERP) 组件和肝脏手术患者并发症发生率之间的关联.
- 确定特定的ERP元素,如果不及时遵循,则与不利结果相关.
主要方法:
- 从2019年1月到2022年12月对接受肝脏手术并提供ERP的患者进行前性数据收集.
- 根据鼻胃管切除,口服恢复,调动和血糖控制来定义不符合性.
- 多变量分析以确定与术后发病率相关的因素.
主要成果:
- 总共分析了192名患者,57.3%接受了微创手术.
- 术后发病率发生在44.8%的患者中,主要并发症发生在13%的患者中.
- 合规患者的并发症率从合规患者的26.9%大幅上升到完全不合规患者的91.2% (p < 0.001).
结论:
- 在肝脏手术中,早期不遵守术后增强恢复协议项目与整体和主要发病率的增加密切相关.
- 严格遵守ERP指导方针对于减轻肝脏手术后期并发症至关重要.
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