角色alvimopan (entereg)在医院胃肠恢复和保持肠切除术后的长度。
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王,国王N,菲利普J, Caraccio T, B Feuerman M,马龙
角色alvimopan (entereg)在医院胃肠恢复和保持肠切除术后的长度。
P t . 2012年9月,37(9):518 - 25所示。
- PubMed ID
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23066346 (在PubMed]
- 文摘
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目的:术后肠梗阻(POI)可以延缓肠切除术后胃肠(GI)复苏。Alvimopan (Entereg),外围地表演mu-opioid受体拮抗剂,被认为有利减少各种结果等措施保持(洛杉矶)的长度和时间从手术出院后partial-bowel,大肠、小肠切除的手术基本吻合。我们进行了一项研究,比较这些结果措施alvimopan-treated患者接受腹腔镜或open-bowel切除对照组。我们也试图确定其他factors-Diagnosis-Related组(DRG)状态,并发症,炎症性肠病、手术类型、年龄、性别、肠道癌症,憩室的疾病,慢性疾病,手术时间预测更为有利的(较短)时间来GI复苏。方法:病人的回顾性图表回顾了在大纽约郊区591个床位的教学医院2010年6月和8月之间。我们五个结果变量描述性统计申请比较alvimopan-treated吸毒者患者。主要的结果变量是从手术出院的时间。次要结果变量的时间通过气体,液体的饮食,坚实的饮食,和洛杉矶。我们比较三组按编码结果变量(329年,最复杂的情况下;330年,中间; and 331, least complicated) to determine which variables influenced these outcome measures. Multivariate analysis with stepwise multiple linear regression analysis was performed to determine independent predictors of shorter times of outcome variables. RESULTS: Of 80 patients, 43 received alvimopan (53.75%), and 37 (46.25%) did not. The female-to-male ratio was about 50:50 (56.25% vs. 43.75%). The mean age (standard deviation) was 66.0 (14.9) years (range, 30-92 years). In the multivariate analysis (adjusted for demographics, DRG status, type of surgery, complications, comorbidities, and operative time), for all of our outcome variables (except for time to a liquid diet), patients receiving alvimopan had shorter times to GI recovery (about 25% less) than controls did (p < 0.05). DRG status, complications, inflammatory bowel disease, type of surgery, and age were also significantly predictive of one or more outcome variables, whereas sex, intestinal cancer, diverticular disease, the number of chronic conditions, and operative time were not predictive of any outcomes. CONCLUSION: GI recovery times were generally shorter for alvimopan-treated patients than for those who did not receive the study drug (P < 0.05). Alvimopan improved quality of life and reduced the cost of surgical care. This medication was considered to be a good choice for the perioperative management of patients requiring segmental bowel resection with primary anastomosis.
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