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在心脏手术后的第一个和第二个术后一天的胸管切除:系统性审查和元分析
Mohamed Saad Rakab1, Ameer Awashra2, Nada Radwan1
1Faculty of Medicine, Mansoura University, Mansoura, Egypt.
在心脏手术后提前切除胸管会缩短住院时间,但会增加心周溢出风险. 虽然对死亡率和感染安全,但对这种实践来说,仔细的患者选择和监测至关重要.
科学领域:
- 心胸外科手术 心胸外科手术
- 关键护理医学 关键护理医学
- 基于证据的医学基于证据的医学.
背景情况:
- 在心脏手术后切除胸管的最佳时间是有争议的,有不同的机构协议.
- 提前清除可能会加速恢复,但会带来诸如液体积累等风险.
- 这一元分析评估了早期与晚期的胸管切除对患者结局的影响.
研究的目的:
- 为了比较心脏手术后早期和晚期胸管切除的临床和程序结果.
- 评估加速胸管切除方案的安全性和有效性.
主要方法:
- 在主要数据库 (Web of Science,SCOPUS,PubMed,Cochrane) 进行系统的文献搜索,直到2025年5月.
- 包括9项研究,包括8557名接受心脏手术的患者.
- 使用聚合风险比率和随机或固定效应模型的平均差异的元分析.
主要成果:
- 早期切除显著增加心周溢出风险 (RR 1.85) 并趋向于更高的多溢出 (RR 1.19).
- 住院时间缩短了1天,提前退院 (MD-1.00天).
- 在死亡率,ICU住院,术后感染或心房动率方面没有发现显著差异.
结论:
- 在死亡率,感染和心房动方面,早期切除胸腔管是安全的.
- 心周溢血的发病率较高需要风险分层和移除后的监测.
- 早期切除胸管的临床决定应该平衡好处与输出风险.
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