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肝移植术后杓状软骨脱位的高发率:一项病例对照研究。

High prevalence of postoperative arytenoid dislocation in patients undergoing liver transplantation: A case-control study.

机构信息

Department of Emergency, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China.

The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.

出版信息

Medicine (Baltimore). 2023 Aug 25;102(34):e34771. doi: 10.1097/MD.0000000000034771.

Abstract

Arytenoid dislocation (AD) is a rare complication of surgery under general anesthesia. The potential factors for AD remain poorly defined, and the identification of risk factors is beneficial for reducing its incidence. We found that patients undergoing liver transplantation appeared to be more susceptible to postoperative AD at our hospital. The present study was designed to clarify this issue. A retrospective hospital-based case-control study was conducted in patients undergoing surgery under general anesthesia between 2017 and 2021. Recorded data for all patients were age, sex, body weight, height, body mass index, position of patients during surgery, duration of surgery, emergency status of surgery, and liver transplantation. Logistic regression analysis was performed to determine risk factors for AD. Thirty thousand one hundred fifty-four patients who underwent general anesthesia between 2017 and 2021 were included. Sixteen (0.05%) patients were diagnosed with AD, including 10 (3.9%) patients among 259 patients who underwent liver transplantation and 6 patients had complications among the 29,895 patients who underwent other operations (P < .0001). Postoperative AD incidence was significantly elevated in patients undergoing liver transplantation. This finding should be clinically relevant and alarming for anesthesiologists and clinicians to help avoid arytenoid dislocation and improve patient outcomes. Further studies that incorporate detailed data are needed to determine risk factors for AD.

摘要

杓状软骨脱位(AD)是全身麻醉下手术的罕见并发症。AD 的潜在因素仍未明确定义,确定危险因素有助于降低其发生率。我们发现在我院,接受肝移植的患者似乎更容易发生术后 AD。本研究旨在阐明这一问题。本研究对 2017 年至 2021 年期间接受全身麻醉手术的患者进行了一项回顾性基于医院的病例对照研究。记录了所有患者的年龄、性别、体重、身高、体重指数、手术期间的体位、手术持续时间、手术紧急情况和肝移植。采用 logistic 回归分析确定 AD 的危险因素。共纳入 2017 年至 2021 年间接受全身麻醉的 3154 例患者。16 例(0.05%)患者被诊断为 AD,其中 259 例肝移植患者中有 10 例(3.9%),29895 例接受其他手术的患者中有 6 例发生并发症(P<0.0001)。接受肝移植的患者术后 AD 发生率显著升高。这一发现对麻醉师和临床医生具有重要的临床意义和警示作用,有助于避免杓状软骨脱位并改善患者结局。需要进一步的研究来确定 AD 的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a207/10470738/babf03ee56dc/medi-102-e34771-g001.jpg

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