Komplicētas žutsakmeņu slimības ārstēšanas izaicinājumi Covid-19 pandēmijas laikā, salīdzinošs grupu pētījums
No Thumbnail Available
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Komplicētā žultsakmeņu slimība ir stāvoklis, kas prasa steidzamu ķirurģisku iejaukšanos. Covid-19 pandēmija ir skārusi visas medicīnas nozares tostarp arī ķirurģiju. Šī pētījuma ietvaros tiek aplūkotas Covid-19 pandēmijas ienestās izmaiņas komplicētās žultsakmeņu slimības diagnostikā un ārstēšanā, ka arī vērtētas atšķirības starp pirms pandēmijas un pandēmijas pacientu grupām. Pētījuma mērķis ir izvērtēt komplicētās žultsakmeņu slimības diagnostisko un ārstniecisko taktiku pirms un Covid-19 pandēmijas laikā.
Retrospektīvi tika ievākti dati par komplicētās žultsakmeņu slimības pacientu laboratorisku analīžu, diagnostikas izmeklējumu rezultātiem un operāciju protokolu aprakstiem. Pacienti tika iedalītas divās grupās: pirms Covid-19 pandēmijas grupa un Covid-19 pandēmijas grupa. Pētījumā gaitā tika noskaidrots, ka pandēmijas laikā komplicētās žultsakmeņu slimības pacientu hospitalizācijas ilgums bija lielāks nekā pirms pandēmijas laika. Šiem pacientiem laparoskopiska kopēja žultsvada sanācija tika pielietota biežāk Covid-19 pandēmijas laikā nekā pirms Covid-19 perioda. Savukārt konvencionāla ķirurģiska metode tika retāk pielietota Covid-19 pandēmijas laikā. Asociācija starp komplicētās žultsakmeņu slimības pacientu sarežģījumiem un pandēmiju netika novērota. Letālo iznākumu ziņā starp abām grupām netika novērota atšķirība.
Pētījumā atsevišķi ir aprakstīti komplicētās žultsakmeņu slimības pacienti, kuriem hospitalizācijas laikā tika atklāta SARS-CoV-2 infekcija, ka arī pacienti ar Covid-19 infekciju anamnēze. Pētījumā tika noskaidrots, ka SARS-CoV-2 pozitīvi pacienti ar komplicēto žultsakmeņu slimību ilgāku laiku pavadīja slimnīcā nekā neinficēti pacienti. SARS-CoV-2 pozitīviem pacientiem kopējā un tiešā bilirubīna līmenis bija augstāks nekā pacientiem bez Covid-19 infekcijas.
Covid-19 pandēmija kā ārkārtas situācija sabiedrības veselības jomā ir uzsvērusi veselības sistēmas noturības nozīmi un aktualizējusi jautājumu par veselības speciālistu, veselības aprūpes iestāžu gatavību un spēju efektīvi reaģēt uz krīzēm. Konkrētajā pētījumā tika pieradīts, ka Rīgas Austrumu klīniskās universitātes slimnīcas “Gaiļezers” stacionāra Vispārējās un neatliekamās ķirurģijas klīnika izrādīja gatavību krīzei.
Complicated gallstone disease is a condition that requires urgent surgical intervention. The Covid-19 pandemic has affected all medical fields, including surgery field. This study describes the changes the Covid-19 pandemic made in the diagnosis and treatment of complicated gallstone disease, as well as the differences between pre-pandemic and pandemic patient groups. The aim of the study is to evaluate the diagnostic and therapeutic tactics of complicated gallstone disease before and during the Covid-19pandemic. Data on the results of laboratory tests, diagnostic examinations and descriptions of surgical protocols in patients with complicated gallstones were retrospectively collected. Patients were divided into two groups: the pre-Covid-19 pandemic group and the Covid-19 pandemic group. The study found that the duration of hospitalization in patients with complicated gallstones was longer during the pandemic than before the pandemic. In these patients, laparoscopic common bile duct exploration was performed more frequently during the Covid-19 pandemic than before the Covid-19 period. In contrast, the open common bile duct exploration was less commonly frequently performed during the Covid-19 pandemic. No association was observed between complications of patients with complicated gallstones and pandemics. There was no difference in lethality between the two groups. Patients with a history of SARS-CoV-2 infection and a history of Covid-19 infection were reported separately from patients with complicated gallstones in the study. The study found that SARS-CoV-2-positive patients with complicated gallstones spent more time in hospital than uninfected patients. Total and direct bilirubin levels were higher in SARS-CoV-2 positive patients than in patients without Covid-19 infection. Covid-19 pandemic as a public health emergency has highlighted the importance of the sustainability of the health system and raised the question of the preparedness and ability of health professionals, healthcare institutions to respond effectively to crises. In this particular case Riga East Clinical University Hospital, stationary “Gaiļezers” General and Emergency Surgery Clinic showed preparedness for the crisis.
Complicated gallstone disease is a condition that requires urgent surgical intervention. The Covid-19 pandemic has affected all medical fields, including surgery field. This study describes the changes the Covid-19 pandemic made in the diagnosis and treatment of complicated gallstone disease, as well as the differences between pre-pandemic and pandemic patient groups. The aim of the study is to evaluate the diagnostic and therapeutic tactics of complicated gallstone disease before and during the Covid-19pandemic. Data on the results of laboratory tests, diagnostic examinations and descriptions of surgical protocols in patients with complicated gallstones were retrospectively collected. Patients were divided into two groups: the pre-Covid-19 pandemic group and the Covid-19 pandemic group. The study found that the duration of hospitalization in patients with complicated gallstones was longer during the pandemic than before the pandemic. In these patients, laparoscopic common bile duct exploration was performed more frequently during the Covid-19 pandemic than before the Covid-19 period. In contrast, the open common bile duct exploration was less commonly frequently performed during the Covid-19 pandemic. No association was observed between complications of patients with complicated gallstones and pandemics. There was no difference in lethality between the two groups. Patients with a history of SARS-CoV-2 infection and a history of Covid-19 infection were reported separately from patients with complicated gallstones in the study. The study found that SARS-CoV-2-positive patients with complicated gallstones spent more time in hospital than uninfected patients. Total and direct bilirubin levels were higher in SARS-CoV-2 positive patients than in patients without Covid-19 infection. Covid-19 pandemic as a public health emergency has highlighted the importance of the sustainability of the health system and raised the question of the preparedness and ability of health professionals, healthcare institutions to respond effectively to crises. In this particular case Riga East Clinical University Hospital, stationary “Gaiļezers” General and Emergency Surgery Clinic showed preparedness for the crisis.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Komplicēta žultsakmeņu slimība. Covid-19 pandēmija., Complicated gallstone disease. The Covid-19 pandemic.