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夜间紧急手术:更高的患者敏度,更大的挑战
Anthony J Duncan1, Wade A Hopper1, Samuel J Bloomsburg1
1Department of Surgery, School of Medicine & Health Sciences, University of North Dakota, Fargo, ND, USA.
The American surgeon
|November 17, 2025
概括
紧急普通手术的结果可能因一天中的时间而异. 夜间手术与较高的损伤控制腹腔切除术 (DCL) 使用和死亡率有关,可能是由于患者敏度和不稳定性增加.
科学领域:
- 手术 手术 手术 术 术
- 紧急医疗 紧急医疗
- 关键护理医学 关键护理医学
背景情况:
- 紧急整形外科 (EGS) 患者的治疗结果可能会受到一天中的时间的影响.
- 之前的研究表明,夜间手术的结果更差.
研究的目的:
- 检查白天和夜间出现的腹腔切除术之间的损伤控制腹腔切除术 (DCL) 使用率和死亡率的差异.
- 评估夜间呈现对DCL和死亡率的影响.
主要方法:
- 从2015年1月到2023年12月的回顾性队列研究.
- 包括在白天 (7:00 AM-5:00 PM) 或夜间 (5:00 PM-7:00 AM) 接受紧急探索性腹腔切除术的患者.
- 主要结局:全因住院患者死亡率. 二次结果:DCL发生率,并发症,重症监护指标和住院时间.
主要成果:
- 在1279名患者中,夜间患者 (44%) 具有更高的ASA第5类比例和更大的术内血管压缩剂使用.
- 损伤控制腹腔切除术在夜间更频繁 (50.4%对38.7%).
- 夜间病例的死亡率较高 (18.3%对14.1%),独立于DCL. 夜间手术与加大ICU入院,机械通风和血管压缩器的使用有关.
结论:
- 与白天手术相比,EGS的夜间手术与更高的DCL利用率和死亡率有关.
- 这些发现很可能是由于患者的敏度更高,夜间血液动力学不稳定.
- 进一步的研究可能会探索减轻夜间EGS结果差异的策略.
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