肝移植中的外科临床实践:一个横截面调查
François M Carrier1,2,3,4, Christian Vincelette5, Helen Trottier6
1Department of Anesthesiology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada. francois.martin.carrier@umontreal.ca.
概括
这项研究调查了临床医生对外科手术期间的肝移植实践,发现了流体管理,凝血治疗和血液动力学监测的各种方法,表明了最佳患者护理的平衡.
科学领域:
- 麻醉学和外科手术期间的医学.
- 移植手术 移植手术
- 临床实践研究 临床实践研究
背景情况:
- 肝移植患者的外科护理是复杂的,需要多学科的专业知识.
- 在全球范围内,肝移植的术后实践缺乏标准化.
- 了解当前的临床实践对于确定需要改进的领域至关重要.
研究的目的:
- 描述肝移植中术后实践的组成部分.
- 为了调查临床医生管理肝移植患者的方法.
- 为了识别外科手术期间护理策略的变化.
主要方法:
- 使用在线工具进行跨截面临床实践调查.
- 电子邮件邀请函发送给加拿大和法国麻醉科医生和专门从事肝移植的外科医生.
- 通过利克特尺度和数值/类别答案收集的数据;结果呈现为中位数或比例.
主要成果:
- 超食道回声心脏图的常规使用很少,但经常用于血液动力学不稳定性.
- 在剖析过程中常用目标定向的血液动力学管理和限制性流体策略.
- 对输血指导的粘弹性测试的多样化使用;对凝血障碍的预防性治疗不一致.
- 关于最大移植缺血时间的矛盾性;用于静脉腔解剖,偏好采用背技术.
结论:
- 在肝移植的术后管理组件中存在显著的差异.
- 临床平衡表明需要进一步研究最佳的外科手术期间策略.
- 目前的实践突出显示,需要在肝移植护理方面制定基于证据的指导方针.
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