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重新审视术前评估的重要性——病例报告

Revisiting the Importance of the Pre-Operative Assessment - A Case Report.

作者信息

Avendano John P, Monica James, Varghese Bobby

机构信息

Department of Orthopaedic Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey.

出版信息

J Orthop Case Rep. 2023 Jul;13(7):52-55. doi: 10.13107/jocr.2023.v13.i07.3750.

Abstract

INTRODUCTION

The available literature underscores the importance of optimizing surgical outcomes through a pre-operative checklist, which includes a review of the medical records and recent test results, changes in medical history, and a physical examination of the cardiovascular system, pulmonary system, and airway.

CASE REPORT

We report a case of a 47-year-old man who decompensated during an outpatient wrist procedure and needed to remain intubated requiring transfer to a hospital. On follow-up with the patient, laboratory work revealed a positive HIV test and CD4 count of 11 cells/mm3, along with a pneumonia consistent with pneumocystis pneumonia, which was unbeknownst to the surgical team before the procedure.

CONCLUSION

This case emphasizes the importance of a thorough history and physical update and pre-operative assessment before operating.

摘要

引言

现有文献强调了通过术前检查表优化手术结果的重要性,该检查表包括病历和近期检查结果回顾、病史变化以及心血管系统、肺部系统和气道的体格检查。

病例报告

我们报告一例47岁男性病例,该患者在门诊手腕手术过程中出现失代偿,需要继续插管并转至医院。对患者进行随访时,实验室检查显示HIV检测呈阳性,CD4细胞计数为11个/立方毫米,同时伴有与肺孢子菌肺炎相符的肺炎,而手术团队在手术前对此并不知情。

结论

该病例强调了手术前全面更新病史、体格检查和术前评估的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a87e/10379242/465e1e6f5ddf/JOCR-13-52-g001.jpg

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