儿科泌尿外科手术患者的功能:国家外科质量改善计划-儿科队列的洞察力
Victor Chalfant1, Carlos Riveros2, Andrew A Stec3
1Division of Urology, SIU School of Medicine, Springfield, IL, USA.
Current urology
|May 16, 2025
概括
在小儿泌尿外科手术中,术前功能检测至关重要. 结果异常的患者面临更高的并发症风险,强调需要更好的风险评估.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
背景情况:
- 脏保护是儿科泌尿外科手术的关键原因,但手术前脏功能评估不是标准的.
- 本研究调查了手术前功能测试的流行情况及其对主要儿科泌尿外科手术结果的影响.
- 在手术后的儿科泌尿病患者中,功能障碍的低诊断有可能存在.
研究的目的:
- 评估儿科泌尿外科手术中术前功能检测的比率.
- 为了确定该人群中异常功能的患病率.
- 确定术前功能与术后并发症之间的关联.
主要方法:
- 分析了2012-2019年国家外科质量改善计划-儿科数据库的数据.
- 纳入标准:接受住院重大泌尿外科手术的儿科患者.
- 通过使用床边施瓦茨方程定义的肌素 (Cr) 水平 (<2年) 或估计的膜过率 (eGFR) (≥2年) 定义的异常功能.
主要成果:
- 在17315名患者中,只有21.9%的患者有记录的Cr值.
- 在7.3%的婴儿,6.3%的儿童和15.0%的青少年中检测到异常的功能.
- 手术前功能异常的患者的再入院,再手术,感染,输血,功能衰竭和尿路感染率明显更高 (p < 0.001).
结论:
- 在接受重大泌尿外科手术的儿科患者中,只有21.9%的儿科患者可获得经过记录的手术前功能测试.
- 术前功能异常与术后并发症率的增加有关,包括功能衰竭和急性功能衰竭.
- 实施标准化风险评估工具可以通过识别患有并发症风险较高的患者,从而使患者受益,这需要进一步调查.
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