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术后流体疗法在胰腺二切除手术后的增强恢复
Sharnice Koek1,2, Johnny Lo3, Rupert Ledger4
1Department of General Surgery, Fiona Stanley Hospital, Murdoch, WA, Australia.
Annals of hepato-biliary-pancreatic surgery
|January 12, 2024
概括
在胰腺突切除术 (PD) 患者接受手术后增强恢复 (ERAS) 的向静脉输液治疗方案没有显著改变发病率. 这种液体疗法在ERAS协议中对于PD患者似乎是安全的.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 在手术后增强康复 (ERAS) 协议中,胰腺双管切除术 (PD) 的最佳外科期间静脉输液管理仍然不清楚.
- 过度饮用液体和可以增加患病率和住院时间.
- 这项研究评估了ERAS的术后0-2天期间在PD患者的特定静脉注射治疗方案.
研究的目的:
- 评估针对性静脉注射液体治疗方案对接受ERAS治疗的PD患者的发病率和停留时间的影响.
- 在ERAS中确定PD后的特定流体治疗方案 (20毫升/千克/天维护,0.5毫莫尔/千克/天) 的安全性和有效性.
主要方法:
- 在ERAS实施之前和之后对PD患者 (2009-2017年) 的回顾性干预队列研究.
- 实施一个向的静脉输液方案:20毫升/千克/天维护,0.5毫莫尔/千克/天.
- 结果指标包括/的使用,住院时间和发病率 (POPF,AKI,大).
主要成果:
- 这项研究包括169名患者 (平均年龄64±11.3岁).
- 该协议的实施显著减少了化物和负荷.
- 多变量分析显示,化物管理并没有独立地影响POPF,大脑或AKI的逗留时间或率.
结论:
- 在ERAS中,术后静脉注射液疗法对PD患者的发病率没有显著影响.
- 尽管患者的并发症增加,但观察到减少住院时间的趋势.
- 针对性流体治疗方案在ERAS中对于PD患者来说似乎是安全的,这需要进一步的前性研究.
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