变量:在雷区面谈中应提到的并发症

M. Stücker
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摘要

目的:探讨医生对静脉曲张治疗并发症的轻重考虑,以规范知情同意程序,提高共同决策水平。方法:采用e-Delphi方法,要求来自10个国家的专家医生在5分李克特量表上将并发症分为“严重”或“轻微”。我们使用Cochrane综述中关于静脉曲张的参考文章来组成并发症列表。结果:与会专家就12项主要并发症达成共识:过敏反应、需要静脉注射抗生素/重症监护室的蜂窝织炎、需要清创的伤口感染、需要输血/手术干预的出血、肺栓塞、需要手术的皮肤坏死、需要修复的动静脉瘘、深静脉血栓形成、淋巴囊肿、热损伤、短暂性脑缺血发作/中风、永久性变色。结论:关于医生认为静脉曲张治疗的主要并发症达成了国际共识。这一共识可能有助于规范医生在静脉曲张治疗前与患者讨论的信息。
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Varikose: Welche Komplikationen im Aufklärungsgespräch genannt werden sollten
Objective: To reach consensus on which complications of varicose vein treatments physicians consider major or minor, in order to standardize the informed consent procedure and improve shared decision-making. Methods: Using the e-Delphi method, expert physicians from 10 countries were asked to rate complications as «major» or «minor» on a 5-point Likert scale. Reference articles from a Cochrane review on varicose veins were used to compose the list of complications. Results: Participating experts reached consensus on 12 major complications: allergic reaction, cellulitis requiring intravenous antibiotics/intensive care, wound infection requiring debridement, hemorrhage requiring blood transfusion/surgical intervention, pulmonary embolism, skin necrosis requiring surgery, arteriovenous fistula requiring repair, deep venous thrombosis, lymphocele, thermal injury, transient ischemic attack/stroke, and permanent discoloration. Conclusion: An international consensus was reached about what physicians consider to be major complications of varicose vein treatments. This consensus may assist in standardizing the information physicians discuss with patients prior to varicose vein treatment.
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