在经过轻微侵入性大动脉置换后,在手术室进行例行输出管
Mihee Lim1, Minho Ju1, Chee-Hoon Lee1
1Department of Cardiovascular and Thoracic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Yangsan 50612, Republic of Korea.
Journal of clinical medicine
|May 28, 2025
概括
通过右前部小型胸腔切除术进行大动脉置换后在手术室内输出患者的输出管是安全有效的. 这种方法减少了重症监护室和住院的时间,支持适合患者的常规采用.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
背景情况:
- 通过右前部小型胸腔切除术 (RAMT) 进行大动脉置换 (AVR) 是一种微创手术方法.
- 在RAMT-AVR之后,在手术室 (在手术桌上) 进行早期输出管的安全性和可行性尚未完全确定.
研究的目的:
- 评估通过RAMT进行的隔离AVR后在桌面上的输出管的可行性和安全性.
- 在这个患者队列中确定成功的桌上输出管的预测因素.
主要方法:
- 通过RAMT进行隔离AVR的423名患者的回顾性分析 (2012年2月 - 2023年12月).
- 排除紧急情况和重复手术.
- 根据输出管的位置进行分类:手术室 (在手术桌上) 与重症监护室 (ICU).
- 多变量后勤回归以确定桌上输出管的预测因素.
主要成果:
- 73.3%的患者在桌上被抽管.
- 桌上输出管与年轻的年龄,较低的EuroSCORE II,较高的手术前白蛋白和较短的心肺绕行术时间有关.
- 在桌面上的输出管显著减少了ICU和医院停留的时间.
- 一个预测模型 (年龄,白蛋白,绕道时间) 实现了78.4%的准确度,用于表上输出管成功.
结论:
- 对大多数通过RAMT进行隔离AVR的患者来说,桌上输出管是安全有效的.
- 这种做法与较低的再灌输率和较短的住院时间有关.
- 对于接受RAMT-AVR的合适候选人来说,支持例行桌上输出.
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