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Christopher McLaughlin1, Lewis J Kaplan1, Isidro Martinez-Casas2
1Perelman School of Medicine, Division of Trauma, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
与直接手术相比,非手术管理 (NOM) 随后的小肠阻塞手术 (SBO) 可能会增加深部手术部位感染 (SSI) 的风险. 这凸显了评估影响操作时间和结果的因素的必要性.
科学领域:
- 手术成果研究的研究结果.
- 胃肠道手术 胃肠道手术
- 传染病流行病学 传染病流行病学
背景情况:
- 博洛尼亚指南为小肠阻塞 (SBO) 提供了三种管理途径.
- 选择途径对术后感染率的影响仍未得到充分研究.
研究的目的:
- 调查SBO管理途径与术后感染发病率之间的关联.
- 为了比较非手术管理 (NOM) 之后的手术 (NOM-T) 和直接到手术 (DTS) 途径之间的结果.
主要方法:
- 这是一项跨国,前性,观察性审计,涉及21个国家的1,737名SBO患者.
- 患者被分为成功的NOM,NOM-T和DTS组.
- 统计比较使用了奇平方或费舍尔精确测试 (p <0.05显著性).
主要成果:
- 操作队列 (NOM-T与DTS) 显示出类似的人口统计数据,但在NOM-T中出现了更多的并发症.
- 肠道缺血症在DTS (33%) 与NOM-T (22.8%) 相比较高.
- 深度手术部位感染 (SSI) 在NOM-T (5.5%) 与DTS (2.8%,p=0.035) 相比更频繁,尽管整体SSI率相似.
结论:
- 在手术前进行非手术性管理的初步试验可能会增加深度SSI的风险.
- 推迟到手术室的时间和医院/外科医生变量等因素可能有助于增加深度SSI风险.
- 进一步评估这些贡献因素是有必要的,以优化患者护理.
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