穿孔性分泌体炎的损害控制手术降低了静脉 rate:一个多中心的国际回顾性队列研究
Maximilian Sohn1,2, Valentin Ritschl3,4, Dario Tartaglia5
1Klinik für Allgemein-, Viszeral- und minimalinvasive Chirurgie, Isarklinikum München, München, Germany.
概括
与传统方法相比,穿孔性分泌体炎的两阶段损害控制策略 (DCS) 显著降低了口腔的发生率. 这种方法提供了一个更好的机会,在医院出院后避免口腔.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 与腹膜炎相关的左结肠穿孔性分泌体炎具有显著的死亡风险.
- 这种疾病的最佳手术治疗仍然是持续辩论的主题.
- 对于严重的病例,越来越多地考虑使用双阶段损害控制策略 (DCS).
研究的目的:
- 为了比较常规应用的两阶段损害控制策略 (DCS) 与传统的非DCS策略的有效性.
- 评估DCS对穿孔性分泌体炎患者口腔间隙率的影响.
- 评估两种手术方法之间的发病率和死亡率的差异.
主要方法:
- 一项国际多中心回顾性队列研究,涉及9家欧洲医院.
- 五家医院经常采用两阶段的DCS,而四家医院则使用传统的一阶段手术作为对照.
- 主要结局:医院出院时的口腔瘤率. 二次结果:发病率和死亡率.
主要成果:
- 分析了558名患者的数据;365人接受了DCS.
- 用DCS治疗的患者具有显著较低的静脉栓率 (45.6%无静脉栓 vs. 20.8%; p=0.001).
- 没有观察到发病率或死亡率的显著差异,但DCS与更长的ICU停留和更多的手术干预有关.
结论:
- 在穿孔性垂炎中,常规应用双阶段DCS会导致无门性排泄的可能性显著增加.
- DCS代表了一种可行的替代性手术策略,用于管理穿孔性分泌体炎,可能改善患者关于静脉形成的结果.
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