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新冠疫情封锁策略对血管外科实践的影响:大截肢手术比往常更多。

Impact of the COVID-19 Lockdown Strategy on Vascular Surgery Practice: More Major Amputations than Usual.

作者信息

Schuivens Puck M E, Buijs Manon, Boonman-de Winter Leandra, Veen Eelco J, de Groot Hans G W, Buimer Thijs G, Ho Gwan H, van der Laan Lijckle

机构信息

Department of Surgery, Amphia Hospital, Breda, The Netherlands.

Department of Surgery, Amphia Hospital, Breda, The Netherlands.

出版信息

Ann Vasc Surg. 2020 Nov;69:74-79. doi: 10.1016/j.avsg.2020.07.025. Epub 2020 Aug 4.

DOI:10.1016/j.avsg.2020.07.025
PMID:32763458
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7402273/
Abstract

BACKGROUND

The aim of this study is to investigate the impact of the coronavirus disease 2019 (COVID-19) lockdown period on the number and type of vascular procedures performed in the operating theater.

METHODS

A total of 38 patients who underwent 46 vascular procedures during the lockdown period of March 16th until April 30th, 2020, were included. The control groups consisted of 29 patients in 2019 and 54 patients in 2018 who underwent 36 and 66 vascular procedures, respectively, in the same time period. Data were analyzed using SPSS Statistics.

RESULTS

Our study shows that the lockdown during the COVID-19 pandemic resulted in a significant increase in the number of major amputations (42% in 2020 vs. 18% and 15% in 2019 and 2020, respectively; P-value 0.019). Furthermore, we observed a statistically significant difference in the degree of tissue loss as categorized by the Rutherford classification (P-value 0.007). During the lockdown period, patients presented with more extensive ischemic damage when than previous years. We observed no difference in vascular surgical care for patients with an aortic aneurysm.

CONCLUSIONS

Measurements taken during the lockdown period have a significant effect on non-COVID-19 vascular patient care, which leads to an increased severe morbidity. In the future, policy makers should be aware of the impact of their measurements on vulnerable patient groups such as those with peripheral arterial occlusive disease. For these patients, medical care should be easily accessible and adequate.

摘要

背景

本研究旨在调查2019年冠状病毒病(COVID-19)封锁期对手术室进行的血管手术数量和类型的影响。

方法

纳入了2020年3月16日至4月30日封锁期内接受46例血管手术的38例患者。对照组由2019年的29例患者和2018年的54例患者组成,他们在同一时期分别接受了36例和66例血管手术。使用SPSS Statistics软件对数据进行分析。

结果

我们的研究表明,COVID-19大流行期间的封锁导致大截肢手术数量显著增加(2020年为42%,而2019年和2018年分别为18%和15%;P值为0.019)。此外,我们观察到根据卢瑟福分类法分类的组织损失程度存在统计学显著差异(P值为0.007)。在封锁期间,患者出现的缺血性损伤比前几年更广泛。我们观察到腹主动脉瘤患者的血管外科护理没有差异。

结论

封锁期间采取的措施对非COVID-19血管患者的护理有显著影响,这导致严重发病率增加。未来,政策制定者应意识到他们的措施对诸如外周动脉闭塞性疾病患者等弱势群体的影响。对于这些患者,医疗护理应易于获得且足够。

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