Kehlet H, Williamson R, Büchler M W, Beart R W
Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen, Denmark.
Colorectal Dis. 2005 May;7(3):245-50. doi: 10.1111/j.1463-1318.2005.00763.x.
Postoperative ileus (POI) can negatively affect patient recovery and morbidity, yet the lack of an internationally accepted definition and clinical management pathway for this condition suggest POI may be under-recognized as a clinical problem. The purpose of this survey was therefore to assess current attitudes of surgeons towards the clinical impact and management of POI.
Telephone interviews were conducted with 230 surgeons from hospitals in the UK, France, Germany, Italy and Spain.
Across Europe, there are differences in the terms surgeons use to refer to delayed recovery of gastrointestinal (GI) function and the symptoms, concerns and risks they associate with this condition. Furthermore, there is marked variation in the attitudes of European surgeons towards minimizing the risk of delayed recovery of GI function and in the strategies to manage POI. Additionally, some of the measures applied most commonly by European surgeons are in contrast to evidence in the literature indicating that they have no benefit for quicker resolution of GI function.
The results suggest that there is a need for clearer definition of the factors that constitute POI, increased recognition of the impact of this condition and improved understanding of the most effective peri-/postoperative care for surgical patients.
术后肠梗阻(POI)会对患者的康复和发病率产生负面影响,但对于这种情况缺乏国际公认的定义和临床管理路径,这表明POI作为一个临床问题可能未得到充分认识。因此,本次调查的目的是评估外科医生目前对POI的临床影响和管理的态度。
对来自英国、法国、德国、意大利和西班牙医院的230名外科医生进行了电话访谈。
在欧洲各地,外科医生用于指代胃肠(GI)功能延迟恢复的术语以及他们与这种情况相关联的症状、担忧和风险存在差异。此外,欧洲外科医生在将GI功能延迟恢复的风险降至最低的态度以及管理POI的策略方面存在显著差异。此外,欧洲外科医生最常用的一些措施与文献中的证据相反,这些证据表明这些措施对更快解决GI功能问题并无益处。
结果表明,需要更明确地定义构成POI的因素,提高对这种情况影响的认识,并更好地理解对外科患者最有效的围手术期/术后护理。