PDF(Pubmed)
Abstract：
Introduction Hartmann\'s procedures are common surgical operations indicated in a wide variety of presentations including colon malignancy, diverticular disease, volvulus, and colovesical and colovaginal fistulas. The procedure is a major undertaking for the patient and those presenting in the emergency setting are often clinically unwell with deranged laboratory investigations. Numerous studies have demonstrated that pre-operative anaemia contributes to increased morbidity and mortality. Applying the conclusions of one study recommending a minimum haemoglobin >12 g/dL level pre-operatively, this audit assessed patient optimisation prior to Hartmann\'s procedure. Materials and methods Patients undergoing Hartmann\'s procedures between May 2016 and February 2020 were identified. Data was collected retrospectively to analyse American Society of Anesthesiology (ASA) grade and pre-operative haemoglobin level. Pre-operative haemoglobin and group and save blood test values were identified pre-and post-intervention. Results Pre-intervention, 15 (21%) of 70 patients had a haemoglobin level <12 g/dL and 63 patients (90%) had a group and save blood test completed on admission. Post-intervention data was collected from 45 patients, with figures improving to five (11%) and 44 (97%) patients, respectively. Conclusion Our flowchart poster distribution and addition to the surgical proforma led to increased patient optimisation prior to Hartmann\'s procedure.
摘要：
介绍Hartmann的手术是常见的外科手术，包括结肠恶性肿瘤，憩室病,扭转,还有结肠膀胱和阴道瘘.该程序对患者来说是一项重大任务，在紧急情况下就诊的患者通常因实验室检查混乱而临床不适。许多研究表明，术前贫血导致发病率和死亡率增加。应用一项研究的结论，建议术前最低血红蛋白水平>12g/dL，此审核评估了患者在Hartmann手术之前的优化情况。材料和方法确定了2016年5月至2020年2月期间接受哈特曼手术的患者。回顾性收集数据以分析美国麻醉学协会（ASA）等级和术前血红蛋白水平。术前血红蛋白和分组和保存血液检测值在干预前后进行鉴定。结果干预前,70例患者中有15例（21％）的血红蛋白水平<12g/dL，63例（90％）的患者在入院时完成了一组并保存血液检查。收集了45名患者的干预后数据，数字增加到5名(11%)和44名(97%)患者，分别。结论在Hartmann手术之前，我们的流程图海报分布和手术形式的增加导致患者优化。
