[高危患者在上腹部和下腹部干预期间及之后的麻醉并发症]。

H J Hartung, A Sommer
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引用次数: 0

摘要

本研究的目的是利用Mannheim风险检查表的风险分类,定量和定性地确定下腹部或上腹部手术干预后的术中和术后并发症。在对体内平衡的影响方面,上腹部和下腹部的手术干预类型可以被认为是可比较的。回顾性分析了386例在胆道、胃(上腹部)或西格马、直肠或回肠(下腹部)行手术的患者的病例记录。记录术前疾病,术中及术后并发症,直至术后第4周。统计学检验采用卡方检验,alpha = 0.05。根据确定的风险分类,两种手术类型的先前疾病发病率都有所增加(心血管疾病和肺部疾病是在这种情况下记录的初步疾病)。如果细分术中术后并发症,上腹部手术术后支气管肺并发症占主导地位,整体术中并发症分布均匀。数据证明,在按照Mannheim风险检查表进行风险评估时,上腹部剖腹手术被低估了,因此该手术在风险检查表中的排名应该高于西格玛和直肠的大规模剖腹手术。除此之外,上腹部手术对肺部风险的增加也不断被证明是事实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Anesthesiologic complications in risk patients during and following upper and lower abdominal interventions].

It was the aim of this study to determine intraoperative and postoperative complications following lower abdominal or upper abdominal surgical interventions both quantitatively and qualitatively using the risk classification of the Mannheim risk check list. The types of surgical interventions in the upper and lower abdomen can be considered as comparable in respect of influence exercised on the homeostasis. The case records of 386 patients were evaluated retrospectively who had been operated on at the biliary tract, stomach (upper abdomen) or sigma, rectum or ileocaecum (lower abdomen). Preceding diseases were noted and recorded, and so were intraoperative and postoperative complications up to the 4th postoperative week. Statistical testing was effected by means of the chi-square test with alpha = 0.05. In accordance with the determined risk classifications, the incidence of preceding diseases increased for both the types of surgery (cardiovascular diseases and pulmonary diseases being the preliminary diseases recorded in this context). If intraoperative and postoperative complications are broken down, there is a dominance of bronchopulmonary complications after upper abdominal surgery postoperatively, and an equal distribution of overall intraoperative complications. The data prove that in assessing the risk according to the Mannheim risk check list, laparotomies of the upper abdomen are underestimated, so that this type of surgery should rank higher in risk check list than large-scale laparotomies at the sigma and rectum. Over and above this, the enhanced pulmonary risk of upper abdominal surgery continuous to be a proven fact.

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