Kabalin C S, Yarnold P R, Grammer L C
Division of Allergy-Immunology, Ernest S. Bazley Asthma and Allergic Diseases Center of Northwestern Memorial Hospital, Chicago, Ill, USA.
Arch Intern Med. 1995 Jul 10;155(13):1379-84.
To determine the incidence of perioperative complications in asthmatic patients who received preoperative treatment with corticosteroids and whether these could be predicted using any study variables such as age, sex, severity of asthma, or surgery type.
Using a retrospective cohort design, we studied 71 asthmatic patients who underwent 89 surgical procedures; 86 of 89 patients received preoperative treatment with systemic corticosteroids. The main outcome measures evaluated were incidence of postoperative bronchospasm, infection, clinical evidence of adrenocortical insufficiency, and death.
Three patients (4.5%) developed mild postoperative bronchospasm; five (5.6%) developed postoperative infections, two of which were wound infections (2.2%); there were no patients with evidence of adrenocortical insufficiency; there was one death related to a neurosurgical intraoperative complication. Incidence of infection was not statistically different from two comparison surgical groups. None of the complications was predicted using any of the study variables.
Asthmatic patients who are treated preoperatively with corticosteroids can undergo surgical procedures with a low incidence of complications.
确定接受术前皮质类固醇治疗的哮喘患者围手术期并发症的发生率,以及是否可以使用任何研究变量(如年龄、性别、哮喘严重程度或手术类型)来预测这些并发症。
采用回顾性队列设计,我们研究了71例接受89例外科手术的哮喘患者;89例患者中有86例接受了术前全身皮质类固醇治疗。评估的主要结局指标为术后支气管痉挛、感染、肾上腺皮质功能不全的临床证据和死亡的发生率。
3例患者(4.5%)发生轻度术后支气管痉挛;5例(5.6%)发生术后感染,其中2例为伤口感染(2.2%);没有患者出现肾上腺皮质功能不全的证据;有1例死亡与神经外科手术术中并发症有关。感染发生率与两个对照手术组相比无统计学差异。使用任何研究变量均无法预测任何并发症。
术前接受皮质类固醇治疗的哮喘患者可接受手术,并发症发生率较低。