背景:性别,在性别的意义上,是一个主要的社会人口统计学特征,已被证明会影响医疗保健结果。术后加速康复理念(ERAS)是一种有效的围手术期管理措施,可降低患者围手术期应激反应。然而,很少有关于这种类型护理下男性和女性患者之间差异的研究。我们旨在分析加速康复的肝胆胰手术患者临床特征的性别差异。
方法:我们招募了接受肝脏检查的患者,胆道,台州医院肝胆胰外科胆囊手术,浙江省,中国,从2021年4月到2021年7月。收集了接受围手术期加速康复的患者的关键措施(即,案例组)。研究组是通过进行1:1的年龄匹配来组建的,性别,慢性疾病,和手术类型。术后风险评估,术后恢复指标,比较男性和女性患者的术后住院时间(天)。
结果:共纳入226名手术患者,其中男性109例(48.23%),女性117例(51.77%)。结果,表示为中位数(最小值,max),如下:女性(1(0,3))和男性(0(0,2))的肺康复风险评估,术后恶心和呕吐的女性(2(1,3))和男性(1(0,2)),女性(31(4,61))和男性(36(10,78))首次排便的时间。显著差异由p值<0.05表示。
结论:我们确定了加速康复的肝胆胰手术围手术期患者的临床预后和表现的性别差异。男性患者围手术期肺康复风险高于女性患者,男性患者首次排便时间长于女性患者。女性恶心呕吐发生率高于男性。
BACKGROUND: Sex, in the sense of gender, is a major social demographic characteristic that has been shown to affect health care outcomes. The concept of enhanced recovery after surgery (ERAS) is an effective perioperative management measure that can reduce the perioperative stress response in patients. However, there are few studies on the differences between male and female patients under this type of care. We aimed to analyze sex differences in clinical characteristics among patients undergoing hepatobiliary and pancreatic surgery with accelerated rehabilitation.
METHODS: We enrolled patients who underwent liver, biliary tract, and gallbladder operations in the Department of Hepatobiliary and Pancreatic Surgery of Taizhou Hospital, Zhejiang Province,
China, from April 2021 to July 2021. Key measures were collected for patients undergoing perioperative accelerated rehabilitation (i.e., the case group). The study group was assembled by performing 1:1 matching for age, sex, chronic disease, and type of surgery. Postoperative risk assessment, postoperative recovery indicators, and postoperative length of hospital stay (days) were compared between male and female patients.
RESULTS: A total of 226 surgical patients were enrolled, including 109 male (48.23%) and 117 female patients (51.77%). The outcomes, presented as the median (min, max), were as follows: pulmonary rehabilitation risk assessment in females (1(0,3)) and males (0(0,2)), postoperative nausea and vomiting in females (2(1,3)) and males (1(0,2)), and time to first defecation in females (31(4,61)) and males (36(10,78)). Significant differences were indicated by p values < 0.05.
CONCLUSIONS: We identified sex differences in the clinical prognosis and performance of perioperative patients undergoing hepatobiliary and pancreatic surgery with accelerated rehabilitation. The perioperative pulmonary rehabilitation risk of male patients was higher than that of female patients, and the time to first defecation was longer in male than in female patients. The incidence of nausea and vomiting in women was higher than in men.