o:18787 Faktori rizika za pojavu intraoperativnih hemodinamskih poremećaja tokom operacija primarnog hiperparatireoidizma doktorska disertacija Risk factors for intraoperative hemodynamic instability during surgery for primary hyperparathyroidism : doctoral dissertation sr Uvod: Cilj rada je da odredi uĉestalost i faktore rizika za pojavu intraoperativnih hemodianmskih poremećaja kod bolesnika sa komorbiditetima pobrgnutih hirurškom leĉenju oboljenja paraštitaste ţlezde. Metodologija: ovo je kohortna studija, u kojoj su ukljuĉena 269 bolesnika ASA 1,2,3 statusa. Ispitivani su sledeći faktori rizika: pol, godine ţivota, indeks telesne mase, ASA status, prijemna dijagnoza, vrsta hirurške intervencije, duţina trajanja operacije, vreme provedeno pod anestezijom,forma primarnog hiterparatireoidizma,vrednosti kalcijuma i fosfata,kao i sledeći komorbiditeti: hipertenzija, kardiomiopatija, poremećaji srĉanog ritma, angina pektoris-ishemijska bolest srca, dijebetes melitus, bubreţne bolesti. Registrovani su sledeći intraoperativni poremećaji: hipertenzija, hipertenzivna kriza, hipotenzija i poremećaji srĉanog ritma (tahikrdija, bradikardija, novonastala intraoperativna atrijalna fibrilacija i ekstrasistole). Za statistiĉku obradu korišćen je Pirsonov Hi kvadrat test, univarijantna i multivarijantna logistiĉka regresiona analizu. Rezultati: većinu bolesnika su ĉinile ţene 195 (87.3%). Intraoperativni hemodinamski poremećaji su registrovani kod 220 bolesnika (81.8%) bolesnika. Najĉesšći intraoperativni poremećaj je bila hipertenzija, registrovana kod 153(56.9%) bolesnika, kao i poremećaji srĉanog ritma kod bolesnika 129(48.0%) . Univarijanta analiza je registrovala sledeće faktore rizika: starije ţivotno doba, ASA 3 status, BMI >25kg/m², trajanje operacije, vreme provedeno pod anestezijom, hipertenzija, kadriomiopatija, vrsta kardiomiopatije. Multivarijantna regiresiona analiza je pokazala da su nezavisni prediktori pojave IOHP: godine starosti, hipertenzija i kardiomiopatija. Zakljuĉak: Intraoperativni hemodinamski poremećaji su ĉesti tokom paratireoidne hirurgije, pre svega intraoperativna hipertenzija. Starije ţivotno doba, hipertenzija i kardiomiopatija kao koegzistirajuće bolesti su nezavisni faktori rizika za pojavu IOHP. Introduction: The aim of this study is to determine the incidence and risk factors for intraoperative hemodianmskih disorder in patients with comorbid pobrgnutih surgical treatment of the parathyroid gland. Methodology: This is a cohort study, which included 269 patients ASA 1,2,3 status. We studied the following risk factors: gender, age, body mass index, ASA status, receiving a diagnosis, type of surgery, duration of surgery, time spent under anesthesia, form the primary hiterparatireoidizma, values of calcium and phosphate, as well as the following comorbidities: hypertension, cardiomyopathy, heart rhythm disorders, angina pectoris-ischemic heart disease, diabetes mellitus, renal disease. Registered the following intraoperative disorders: hypertension, hypertensive crisis, hypotension, and heart rhythm disorders (tahikrdija, bradycardia, the new intraoperative atrial fibrillation and extrasystoles). For statistical analysis we used the Pearson Chi-square test, univariate and multivariate logistic regression analysis. Results: The majority of patients were women 195 (87.3%). Intraoperative hemodynamic disturbances were registered in 220 patients (81.8%) patients. Najĉesšći intraoperative disorder was hypertension, deposited with the 153 (56.9%) patients, as well as cardiac rhythm disorders in patients 129 (48.0%). Univariate analysis has registered the following risk factors: older age, ASA 3 status, BMI> 25kg / m², duration of operation, time spent under anesthesia, hypertension, kadriomiopatija, type of cardiomyopathy. Regiresiona Multivariate analysis showed that independent predictors of occurrence IOHP: age, hypertension and cardiomyopathy. Conclusion: Intraoperative hemodynamic disturbances are common during parathyroid surgery, primarily intraoperative hypertension. Older age, hypertension and cardiomyopathy as a coexisting disease are independent risk factors for the occurrence of IOHP. medicina - anesteziologija / Medicine - Anaesthesiology Datum odbrane: 20.09.2018. faktori rizika, paratireoidna hirurgija, hipertenzija, hipotenzija, poremećaji srĉanog ritma risk factors, parathyroid surgery, hypertension, hypotension, heart rhythm disorders 616.447-089(043.3) yes 50663695 91552101 6191 91552100 50663695 2018-11-21T12:38:33.053Z 45 no 46 mentor Vera, 1967- Sabljak 2018 63 mentor Nevena, 1956- Kalezić 2018 63 komentor Vladan, 1967- Živaljević 2018 63 član komisije Ivan, 1955- Paunović 2018 63 član komisije Branislava, 1959- Ivanović 2018 63 član komisije Aleksandar Pavlović 2018 158 listova 1983058 http://phaidrabg.bg.ac.rs/o:18787 no yes 3 2018-11-21T12:38:33.320Z 70 11 1066950 1067017 1067018 faktori rizika, paratireoidna hirurgija, hipertenzija, hipotenzija, poremećaji srĉanog ritma risk factors, parathyroid surgery, hypertension, hypotension, heart rhythm disorders 616.447-089(043.3) 1738 11A32 2018