大型紧急腹部手术后的术后肺部并发症:发病率,风险因素和结果 - 一项观察性研究
Andreas Werner Nærum1,2,3, Dunja Kokotovic4,5, Jakob Burcharth4,6,5
1Emergency Surgery Research Group (EMERGE) Copenhagen, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark. andreas.werner.naerum@regionh.dk.
Journal of anesthesia
|February 26, 2026
概括
手术后肺部并发症 (PPC) 影响近40%的患者在紧急腹部手术后. 识别ARISCAT评分和脆弱性等风险因素对于改善结果和降低死亡率至关重要.
科学领域:
- 医学研究 医学研究
- 外科手术的结果
- 肺部医学 肺部医学
背景情况:
- 手术后的肺部并发症 (PPC) 在紧急腹部手术后很常见.
- PPC增加了患者的发病率,死亡率和医疗保健费用.
- 确定特定的风险因素对于有针对性的干预措施至关重要.
研究的目的:
- 为了确定在接受重大紧急腹部手术的患者中PPC的发生率.
- 为了识别与PPC发展相关的术后风险因素.
- 分析PPC对30天死亡率的影响.
主要方法:
- 从2021年1月到2023年12月对1080名患者进行的单中心观察性研究.
- 数据收集包括手术前,手术内和手术后的变量.
- 多变量后勤回归分析了PPC和严重PPC的风险因素.
主要成果:
- 近40%的患者 (39.9%) 经历了至少一个PPC.
- 严重的PPC发生在13.9%的患者中.
- 确定的危险因素包括高的ARISCAT分数,肺部疾病,高血压,虚弱,ICU入院,受污染的伤口,穿孔,重手术和胸.
结论:
- 几种独立的风险因素导致PPC超出了既定的预测因素.
- PPC显著提高了30天死亡率 (任何PPC的21.0%,严重PPC的46.3%).
- 对这些风险因素的进一步研究可能会改善患者的管理,并减少并发症.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
853
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
853
Peripheral Artery Disease V: Postoperative Nursing Management
462
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
462
Cardiomyopathy VII: Pre and Post Operative Nursing Management
400
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
400
Endoscopic Studies II: Thoracocentesis
1.7K
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
1.7K
Aneurysm IV: Nursing Management
541
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
541
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
777
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
777

