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选择性结肠癌切除后不计划的重症监护病房入院:基于人口的注册研究
Sofia Dahlberg1,2, Tomas Vedin3, Ingvar Syk3
1Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden.
在结肠癌手术后不计划的重症监护室入院增加了死亡率. 手术重新干预导致了晚些时候的入院和更糟糕的结果,需要更早的识别和量身定制的监测.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 密集护理医学 密集护理医学
背景情况:
- 在选择性结肠癌手术后的非计划性重症监护病房入院的发生率,病因和结果尚未确定.
- 这项研究旨在调查瑞典选择性结肠癌切除后不计划性入院重症监护室的发生率和相关因素.
研究的目的:
- 为了确定选择性结肠癌手术后非计划性重症监护病房入院的发生率.
- 确定与非计划性重症监护病房入院相关的因素.
- 分析与非计划性重症监护病房入院相关的结果和死亡率.
主要方法:
- 在瑞典 (2010-2019) 进行全国性的回顾性注册表研究.
- 包括接受治疗意图的选择性结肠癌切除的成年患者.
- 排除了患有远程转移,直肠或尾瘤的患者. 分析了来自瑞典结肠直肠癌登记和瑞典重症监护登记的数据.
主要成果:
- 在23,891名患者中,5.6%需要非计划性入院重症监护室.
- 接受治疗的患者年龄较大,患病并发症较多,并且更有可能接受开放性手术.
- 手术重复干预占入院病例的43%,以后的鉴定和较差的结果. 腹腔镜手术与减少入院和降低死亡率有关.
结论:
- 非计划的重症监护病房入院显著增加了选择性结肠癌手术后的短期和长期死亡率.
- 需要再次进行手术的患者的结果更糟,这强调了早期识别的必要性.
- 量身定制的术后监测策略对于改善这些高危患者的治疗结果至关重要.
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