走向健行性大肠切除术的道路. 在可行性研究期间患者的结果和经验
Ellen Coeckelberghs1, Albert Wolthuis2, An Teunkens3
1Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium.
Annals of surgery
|August 7, 2025
概括
一晚停留 (ONS) 切除管道,利用远程监控,显著减少住院时间 (LOS),而不会增加并发症. 与传统的增强恢复途径 (ERP) 相比,这种方法提高了患者的满意度和恢复.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术途径优化手术途径优化
- 最少侵入性的手术
背景情况:
- 增强恢复途径 (ERP) 是结直肠外科手术的标准.
- 同一天排放 (SDD) 和一夜逗留 (ONS) 协议显示可行性,但需要强大的远程监控.
- 可扩展性和延迟并发症诊断是对较新的协议的担忧.
研究的目的:
- 标准化和实施一晚住宿 (ONS) 切除术途径.
- 通过远程监测评估ONS切除术的可行性和结果.
- 为了比较ONS集体检查结果与传统的ERP.
主要方法:
- 实现多式联机远程监控系统 (互动家庭监控应用程序,可穿戴传感器,集中式仪表板).
- 实时追踪生命体征,每天两次问卷和连续血液检查 (POD 1, 3, 5).
- 1:1配对对照组将ONS与传统ERP进行比较.
主要成果:
- ONS患者的住院时间中位数显著缩短 (1天而不是4天).
- 在ONS患者的术后第一天,术后疼痛得分较低 (VAS -3.0).
- 患者满意度高 (8.5/10),身体活动水平迅速改善.
结论:
- 通过手术前教育和远程监测支持的ONS切除术可以减少LOS,而不会影响安全.
- 该ONS途径显示了高的患者满意度和与传统ERP可比的术后结果.
- 远程监控和远程医疗支持对于成功实施ONS至关重要.
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