巴西一家转诊中心的新冠肺炎患者急诊腹部手术后的结果。
Outcomes after emergency abdominal surgery in COVID-19 patients at a referral center in Brazil.
作者信息
Rasslan Roberto, Dos Santos Jones Pessoa, Menegozzo Carlos Augusto Metidieri, Pezzano Alvaro Vicente Alvarez, Lunardeli Henrique Simonsen, Dos Santos Miranda Jocielle, Utiyama Edivaldo Massazo, Damous Sérgio Henrique Bastos
机构信息
Division of General Surgery and Trauma, Department of Surgery, University of Sao Paulo, Av Dr Eneas de Carvalho Aguiar, 255, Sao Paulo, 05403000, Brasil.
出版信息
Updates Surg. 2021 Apr;73(2):763-768. doi: 10.1007/s13304-021-01007-5. Epub 2021 Feb 24.
PURPOSE
COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery.
METHODS
We performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020.
RESULTS
Eighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO/FiO lower than 200 and more than 50% of parenchymal compromise on chest tomography. The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%.
CONCLUSION
Both postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies.
目的
新型冠状病毒肺炎（COVID-19）与接受手术患者的高发病率和死亡率相关。与择期手术不同，急诊手术不应推迟。我们旨在评估接受急诊腹部手术的COVID-19患者的特征和结局。
方法
我们对2020年4月至2020年8月接受急诊手术的COVID-19患者的围手术期数据进行了回顾性分析。
结果
因腹部不适对82例患者进行了评估，其中22例接受了急诊手术。急性生理与慢性健康状况评分系统（APACHE）II和简化急性生理学评分（SAPS）的平均值分别为18.7和68。6例患者的动脉血氧分压/吸入氧分数（PaO₂/FiO₂）低于200，胸部断层扫描显示超过50%的实质损害。急诊手术最常见的指征是疝气（6例；27.2%）。中位住院时间为30天，只有2例患者需要再次手术。术后，10例（43.3%）患者需要机械通气，平均时间为6天。总死亡率为31.8%。
结论
对于有呼吸功能不全和腹部急症的COVID-19患者，术后发病率和死亡率均很高。
Zotero 插件