优化接受高风险腹部神经母细胞瘤切除的儿童的术后管理
William G Lee1,2, Danny Lascano1, Samiza B Palmer1
1Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
The American surgeon
|January 20, 2024
概括
在高风险神经母细胞瘤 (HR-NB) 手术中避免鼻胃管 (NGT) 会加速食. 神经轴麻醉会增加尿导管的使用,但不会影响儿科HR-NB患者停留时间或阿片类药物的使用.
科学领域:
- 儿科手术 儿科手术
- 在瘤学瘤学.
- 麻醉学 麻醉学
背景情况:
- 手术切除是高危神经母细胞瘤 (HR-NB) 的关键.
- 对于HR-NB手术的外科手术管理有很大的差异.
- 针对成人的标准化增强恢复实践 (ERP) 正在儿童HR-NB患者中进行评估.
研究的目的:
- 在接受腹部HR-NB开放切除的儿科患者中评估两名成年ERP.
- 评估避免常规鼻胃管 (NGT) 使用的影响.
- 评估神经轴麻醉的影响.
主要方法:
- 对患有腹部HR-NB的儿科患者的回顾性审查 (12/2010-7/2020).
- 评估ERP:避免常规的鼻胃管 (NGT) 使用和使用神经轴麻醉.
- 主要结局:进入肠道摄入的时间,尿导管使用,阿片类药物利用和停留时间 (LOS).
主要成果:
- 避免NGT导致更早的肠道摄入 (P = .03).
- 神经轴麻醉增加了尿导管的使用 (P < .01) 和持续时间 (P = .02) 没有影响阿片类药物的使用 (P = .77).
- 无论是避免NGT (P = .68),还是使用神经轴麻醉 (P = .89),都没有影响术后的LOS.
结论:
- 在儿科HR-NB患者中应避免术后NGT,以促进更早开始饮食.
- 神经轴麻醉需要尿导管的使用,而不减少阿片类药物的使用,使其益处不清楚.
- 为儿科HR-NB患者优化ERP需要仔细考虑NGT避免和神经轴麻醉的影响.
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