心胸外科手术中的术后传染性肺炎:系统性审查和元分析
Said Khallikane1, Rachid Seddiki2, Issam Serghini3
1Anesthesiologist Cardiothoracic Anesthesia-Cardiovascular ICU, Anesthesiology-ICU-Emergency Department, Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Kingdom of Morocco., Marrakeck, Marrakech-Safi, 40000, Morocco.
手术后传染性肺炎 (PIP) 影响了心胸手术后14.8%的患者. 关键的风险因素,如长时间的通风和70岁以上的年龄,可以作为预防的目标.
科学领域:
- 心胸外科手术 心胸外科手术
- 肺部医学 肺部医学
- 关键护理医学 关键护理医学
背景情况:
- 手术后传染性肺炎 (PIP) 是心胸手术后的一个严重并发症.
- 它导致发病率增加,重症监护室 (ICU) 停留时间更长,医疗保健成本更高.
研究的目的:
- 系统地审查和分析PIP的发病率.
- 为了确定心胸外科手术后与PIP相关的外科风险因素.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 在PubMed,Embase和Scopus搜索了从2021年1月到2023年12月的研究.
- 包括六项高质量的队列研究,涉及4,392名患者;使用纽卡斯尔-太华尺度评估质量.
主要成果:
- 聚合PIP的发病率为14.8% (95%CI,10.6%-19.2%). 这是一个很好的例子.
- 发病率因手术类型而异:胸部瘤 (17.2%),门手术 (15.8%) 和CABG (13.5%).
- 确定了重要的危险因素:长时间的机械呼吸>48小时 (OR:3.46),年龄>70 (OR:2.71),COPD (OR:2.95),心肺旁路>120分钟 (OR:2.63),LVEF <40% (OR:2.38).
结论:
- 在心胸外科手术中,PIP仍然是一个关键的术后挑战.
- 识别风险因素可以制定有针对性的预防策略.
- 策略包括早期输出管,肺部优化和标准化护理途径,以减少PIP发病率并改善患者的治疗结果.
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