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定义最佳的空白后残留体积值,以预测脊柱手术中延迟的术后尿
Jaenam Lee1, Kyung-Soo Suk1, Byung Ho Lee1
1Department of Orthopedic Surgery, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
概括
新的空虚后残留 (PVR) 值可以预测脊髓手术后的延迟术后尿路保留 (POUR). 这些精细的值提高了早期检测和个性化护理的患者经历尿路保留.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 神经外科 神经外科
- 麻醉学 麻醉学
背景情况:
- 手术后尿 (POUR) 是脊椎手术后的常见并发症,导致长时间住院和增加发病率.
- 目前对POUR的诊断标准是基于两个连续300毫升的空后残留量 (PVR),可能无法充分识别患有延迟保留风险的患者.
研究的目的:
- 为了确定精细的PVR截止值来预测脊柱手术患者的延迟POUR.
- 根据性别和年龄等风险因素对这些门进行分层,以加强术后空洞护理协议.
主要方法:
- 一个回顾性,单中心的队列研究,包括310名接受选择性胸脊椎手术的成年患者.
- 福利导管切除后测量了PVR体积;延迟的POUR被定义为PVR > 300mL在空化护理后.
- 使用多变量逻辑回归和ROC曲线分析来识别风险因素,并根据性别,年龄,手术水平和抗胆固醇药物评分 (ADS) 分层确定最佳PVR值.
主要成果:
- 延迟POUR发生在11.9%的患者中,与年龄较大,初始PVR较高和ADS≥2.2有关.
- 预测延迟POUR的最佳PVR值被确定为男性61毫升 (AUC=0.68) 和女性101毫升 (AUC=0.77).
- 较高风险子组,包括多次手术水平或较高ADS水平的子组,可使用较低的门值.
结论:
- 精细化,分层化的PVR截止值可以有效地预测脊柱手术患者的延迟POUR.
- 这些发现支持走向个性化术后排泄护理的趋势,能够更早地检测和干预尿.
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