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异丙托溴铵对慢性阻塞性肺疾病(COPD)开颅手术患者术后呼吸并发症发生情况的影响:一项全国多中心回顾性研究。

Effects of ipratropium bromide on the occurrence of postoperative respiratory complications in craniectomy patients with COPD: A nationwide multicenter retrospective study.

作者信息

Du Zhuoying, Huang Xiaoqian, Feng Yi, Yan Wei, Xu Dan, Sun Xiaoou, Wu Chao, Zheng Yongke, Zeng Longhuan, Xiong Xiaowei, Liu Yuankun, Zhang Chenbo, Luo Jianfeng, Hu Jin

机构信息

Department of Neurosurgery, Huashan Hospital of Fudan University.

Department of Biostatistics, School of Public Health, Fudan University.

出版信息

Medicine (Baltimore). 2020 Jun 26;99(26):e20836. doi: 10.1097/MD.0000000000020836.

Abstract

INTRODUCTION

Postoperative pulmonary complications (PPCs) are common and associated with increased morbidity, mortality, and medical cost. They are gaining increasing concerns among patients receiving neurological surgery. Chronic obstructive pulmonary disease (COPD) affect a large section of whole population and is also one of the risk factors of PPCs in the perioperative setting. Ipratropium bromide is the inhalation solution for the treatment of COPD. Studies showed the perioperative nebulization of ipratropium bromide could increase the lung function and decrease the incidence of postoperative pneumonia in COPD patients underwent thoracic surgery. The purpose of this study is to investigate the effect of perioperative nebulization of ipratropium bromide on PPCs in COPD patients underwent neurosurgical surgery.

METHODS AND ANALYSIS

This study is a multicenter retrospective study in China. Patients who meet the inclusion/exclusion criteria are selected from 7 neurosurgical centers in China. According to whether ipratropium bromide is used in perioperative period, the patients are divided into exposure group and control group. The primary outcome is the incidence of postoperative pneumonia. Secondary outcomes are unplanned intubation, postoperative mechanical ventilation ≥ 48 hours, respiratory failure, atelectasis, death, and length of stay.

ETHICS AND DISSEMINATION

This study was approved by the ethics committee (EC) of the School of Public Health, Fudan University, Shanghai, China. Waived by the ethics committee, no written consent form was obtained since we used the registry data. The study results will be communicated via publication.

TRIAL REGISTRATION NUMBER

ChiCTR1900022552.

摘要

引言

术后肺部并发症(PPCs)很常见,与发病率、死亡率及医疗费用增加相关。它们日益受到接受神经外科手术患者的关注。慢性阻塞性肺疾病(COPD)影响着很大一部分人群,也是围手术期PPCs的危险因素之一。异丙托溴铵是用于治疗COPD的吸入溶液。研究表明,围手术期雾化吸入异丙托溴铵可改善COPD患者的肺功能,并降低其接受胸外科手术后肺炎的发生率。本研究旨在探讨围手术期雾化吸入异丙托溴铵对接受神经外科手术的COPD患者PPCs的影响。

方法与分析

本研究是一项在中国开展的多中心回顾性研究。从中国7家神经外科中心选取符合纳入/排除标准的患者。根据围手术期是否使用异丙托溴铵,将患者分为暴露组和对照组。主要结局是术后肺炎的发生率。次要结局包括非计划插管、术后机械通气≥48小时、呼吸衰竭、肺不张、死亡及住院时间。

伦理与传播

本研究已获得中国上海复旦大学公共卫生学院伦理委员会(EC)的批准。由于使用的是登记数据,伦理委员会豁免了获取书面知情同意书的要求。研究结果将通过发表进行交流。

试验注册号

ChiCTR1900022552。

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