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在复杂的大动脉手术前进行预康复的好处
Thomas Mesnard1,2, Maxime Dubosq1, Louis Pruvot1
1Service de Chirurgie Vasculaire, Centre de l'Aorte, CHU Lille, 59000 Lille, France.
Journal of clinical medicine
|June 10, 2023
概括
手术前干预和手术后增强恢复 (ERAS) 可以改善接受开放性大动脉手术 (OAS) 的患者的结果. 在复杂的大动脉手术前优化患者的健康状况对于减少不良事件和促进恢复至关重要.
科学领域:
- 血管外科 血管外科
- 心胸外科手术 心胸外科手术
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 复杂的大动脉疾病的开放大动脉手术 (OAS) 涉及显著的生理压力,特别是在并发症患者中.
- 心脏和肺部并发症是OAS后常见的不良事件,与患者的功能状态和并发症有关.
- 虽然内血管选择越来越多,但OAS仍然是一个至关重要的,持久的治疗方法,需要专门的多学科团队.
研究的目的:
- 审查手术前干预措施对OAS风险因素管理的原则和益处.
- 讨论预康复和手术后增强康复 (ERAS) 协议在优化患者治疗结果中的作用.
- 突出需要进一步的证据支持ERAS在OAS的实施.
主要方法:
- 对OAS中术前干预和ERAS现有文献的叙述性审查.
- 对导致复杂大动脉疾病中术后不良事件的风险因素的分析.
- 讨论目前的证据和ERAS在血管外科手术的未来方向.
主要成果:
- 术前干预,包括预康复,可以减轻与OAS相关的风险,特别是肺部并发症.
- 手术后增强恢复 (ERAS) 原则,尽管OAS的证据有限,但表明有望改善术后恢复.
- 患者的并发症和功能状态显著影响OAS后不良事件的发生率.
结论:
- 预康复和ERAS是改善开放性大动脉手术结果的有价值的概念.
- 为了在OAS中建立ERAS协议的强有力的证据,需要进行进一步的研究.
- 采用ERAS作为OAS护理的标准,有可能提高患者的康复率并减少并发症.
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