Borlase B, Simon J S, Hermann G
Surgery. 1987 Jul;102(1):15-8.
The reports on surgical techniques that specifically focus on the management and outcome of patients on chronic hemodialysis (CHD) who undergo major intra-abdominal procedures--particularly of an emergency nature--are few. It is hoped that by analysis of our experience the nature of the problem can be further clarified and guidelines for clinical care can be formulated. Thirty-two cases which encompass a 7-year period (1978 to 1985), were reviewed. Seventeen patients underwent elective surgery and fifteen underwent emergency intervention. There was a wide range of cases that were similar to those most generally seen in an acute-care teaching hospital. The morbidity and mortality rates in elective surgery patients were 12% and 6%, respectively, while in the emergency cases, these rates were 62% and 47%. Patients with diabetes had the highest morbidity and mortality. These results were analyzed, and we conclude that CHD patients at risk with a surgically correctable condition should be considered for elective intervention, even if they are currently free of symptoms. This may be particularly true for CHD patients with diabetes.
专门针对接受重大腹部手术（尤其是急诊手术）的慢性血液透析（CHD）患者的管理和治疗结果的外科技术报告很少。希望通过对我们经验的分析，能进一步阐明问题的本质，并制定临床护理指南。回顾了涵盖7年时间（1978年至1985年）的32例病例。17例患者接受了择期手术，15例接受了急诊干预。病例范围广泛，与急性护理教学医院中最常见的病例相似。择期手术患者的发病率和死亡率分别为12%和6%，而急诊病例中，这些比率分别为62%和47%。糖尿病患者的发病率和死亡率最高。对这些结果进行了分析，我们得出结论，即使目前无症状，有手术可矫正病情的CHD高危患者也应考虑进行择期干预。对于患有糖尿病的CHD患者来说尤其如此。
