Enfoque de la cirugía abdominal en pacientes VIH positivos en el Hospital Regional II IESS Dr. Teodoro Maldonado Carbo
Fecha
2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
A raíz de la pandemia de VIH en el mundo surgió el concepto de precauciones universales, las que han modificado en gran medida la forma de enfrentar el contacto con sangre y secreciones, debiendo constituirse en una forma habitual y no excepcional de enfrentar a pacientes quirúrgicos, manejo de muestras de líquidos corporales, curaciones y todo tipo de procedimientos invasivos. En este contexto esta investigación tuvo como propósito determinar los resultados quirúrgicos de los pacientes VIH positivos intervenidos por cirugía Abdominal, se determinó: el perfil epidemiológico de los pacientes, las principales complicaciones, factores de riesgo de morbilidad mortalidad y estableció las consideraciones psicológicas de los cirujanos al intervenir quirúrgicamente a estos, trabajo que se realizó en el área de cirugía del Hospital Regional 2 IESS ―Dr. Teodoro Maldonado Carbo‖, el universo incluye a los pacientes intervenidos por cirugía abdominal, mediante un estudio de tipo descriptivo analítico, con diseño no experimental, longitudinal, retrospectivo durante el periodo 2005 –2010. Los resultados definieron un perfil clínico de pacientes entre 31 – 40 años (34%), 77% de sexo masculino, 71% área urbana, 43% obreros y con ingresos inferiores a $300,00 (89%). El 48% de los pacientes se encontraba entre 4 y 6 años de habérsele detectado VIH y el 34% diagnóstico de SIDA. El diagnóstico más frecuente fue apendicitis y hernia (34% y 30% respectivamente). La tasa de morbilidad fue del 34%, donde la complicación más frecuente fueron abscesos (58,3%) y dehiscencia (16,7%). El 47% de los médicos entrevistados siempre piden un examen de VIH en sangre antes de las cirugías, y el 57,9% siguen el protocolo haciendo firmar el consentimiento informado. El 81,6% de los médicos tienen temor de infectarse al saber que el paciente es VIH positivo. Se concluye que la condición de ser VIH no representan un riesgo asociado de complicaciones en cirugías abdominales en esta población lo que favorece la recuperación postoperatoria.
Following the HIV pandemic in the world did the concept of universal precautions, which have greatly changed the shape to face contact with blood and secretions, and must become a normal way and not face exceptional surgical patients, sample handling, and healing all kinds of invasive procedures. This investigation was to determine the surgical outcomes of HIV patients operated on for abdominal surgery, to achieve this we determined the epidemiological profile of patients, major complications were reported to determine risk factors for mortality and morbidity established psychological considerations of surgeons to perform surgery to, work performed in the area of surgery 2 IESS Regional Hospital "Dr. Teodoro Maldonado Carbo ", the universe includes patients operated on for abdominal surgery, using a descriptive analytic study, with a nonexperimental, longitudinal, retrospective during the period from 2005 to 2010. The results defined a clinical profile of patients aged 31-40 years (34%), 77% male, 71% urban, 43% and workers earning less than $ 300.00 (89%). 48% of the patients were between 4 and 6 years of having been detected and 34% HIV AIDS diagnosis. The most frequent diagnosis was appendicitis and hernia (34% and 30% respectively). The morbidity rate was 34%, where the most frequent complication was abscess (58.3%) and dehiscence (16.7%). 47% of the physicians surveyed always ask an HIV test in blood before surgery, and 57.9% following the protocol by signing the informed consent. The 81.6% of doctors are afraid of being infected to know that the patient is HIV positive. We conclude that HIV status be no risk of complications associated with abdominal surgery in this population which favors postoperative recovery
Following the HIV pandemic in the world did the concept of universal precautions, which have greatly changed the shape to face contact with blood and secretions, and must become a normal way and not face exceptional surgical patients, sample handling, and healing all kinds of invasive procedures. This investigation was to determine the surgical outcomes of HIV patients operated on for abdominal surgery, to achieve this we determined the epidemiological profile of patients, major complications were reported to determine risk factors for mortality and morbidity established psychological considerations of surgeons to perform surgery to, work performed in the area of surgery 2 IESS Regional Hospital "Dr. Teodoro Maldonado Carbo ", the universe includes patients operated on for abdominal surgery, using a descriptive analytic study, with a nonexperimental, longitudinal, retrospective during the period from 2005 to 2010. The results defined a clinical profile of patients aged 31-40 years (34%), 77% male, 71% urban, 43% and workers earning less than $ 300.00 (89%). 48% of the patients were between 4 and 6 years of having been detected and 34% HIV AIDS diagnosis. The most frequent diagnosis was appendicitis and hernia (34% and 30% respectively). The morbidity rate was 34%, where the most frequent complication was abscess (58.3%) and dehiscence (16.7%). 47% of the physicians surveyed always ask an HIV test in blood before surgery, and 57.9% following the protocol by signing the informed consent. The 81.6% of doctors are afraid of being infected to know that the patient is HIV positive. We conclude that HIV status be no risk of complications associated with abdominal surgery in this population which favors postoperative recovery
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Cirugía abdominal, Virus de inmunodeficiencia humana, Epidemiología descriptiva, Epidemiología analítica, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador