慢性免疫抑制对紧急整体手术结果的影响
Scott C Levy1,2, Patrick L Johnson1,2, Cody L Mullens1,2
1Department of Surgery, University of Michigan, Ann Arbor, MI.
Journal of the American College of Surgeons
|February 16, 2026
概括
接受免疫抑制药物治疗的患者在紧急手术中面临更高的死亡率,特别是在探索性腹腔切除术等重大手术中. 然而,像尾切除和胆囊切除这样的常见手术没有增加死亡风险.
科学领域:
- 手术成果研究的研究结果.
- 免疫抑制和患者安全
- 紧急的一般外科手术.
背景情况:
- 接受免疫抑制剂的患者有增加的手术并发症风险.
- 免疫抑制对紧急整体手术 (EGS) 结果的影响尚不清楚.
- 慢性免疫抑制患者数量的增加可能会显著影响EGS的结果.
研究的目的:
- 调查慢性免疫抑制对紧急整体外科手术 (EGS) 结果的影响.
- 确定先前存在的免疫抑制是否会影响EGS患者的死亡率和并发症率.
- 根据特定的EGS程序分析结果.
主要方法:
- 一个全州的EGS协作数据库的回顾性分析.
- 包括接受胆囊切除术,尾切除术,小肠阻塞手术或新兴探索性腹腔切除术的患者.
- 使用平衡和倾向性得分匹配的风险调整结果.
主要成果:
- 在30,073名EGS患者中,5.1%的人患有慢性免疫抑制.
- 免疫抑制与较高的死亡率,并发症,感染,败血症和整体再入院有关.
- 只有新兴的探索性腹腔切除术显示免疫抑制的死亡率增加;其他手术没有.
结论:
- 慢性免疫抑制在EGS中很常见,并且与更糟糕的结果有关,特别是在像探索性腹腔切除术这样的大型手术中.
- 较不复杂的EGS手术 (胆囊切除术,尾切除术) 可以安全地进行,而不会增加免疫抑制患者的死亡风险.
- 虽然非致命的并发症可能会增加,但在这个队列中,对于更简单的EGS手术,死亡风险不会增加.
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