患有脏疾病的患者接受腹手术的管理:一种多学科的方法
Aleksandra Kukla1, Yogish C Kudva2, Pavel Navratil3
1Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Von Liebig Transplant Center, Department of Transplantation Surgery, Mayo Clinic, MN, USA.
Mayo Clinic proceedings
|March 3, 2024
概括
腹腔外科手术,特别是袖子胃切除术,在等待移植的慢性病 (CKD) 患者中对肥胖有好处. 仔细选择患者和多学科护理对于管理代谢变化和改善移植结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 腹部外科 腹部外科
- 移植医学 移植医学
背景情况:
- 肥胖是慢性脏病 (CKD) 患者的重要并发症.
- 腹腔外科手术,特别是袖子胃切除术 (SG),越来越多地用于肥胖的CKD患者,通常是为了促进移植 (KT).
- 管理CKD患者的SG结果存在挑战,包括潜在的肌肉和骨代谢以及独特的营养需求.
研究的目的:
- 审查关于晚期CKD (4-5D阶段) 和袖子胃切除术结果的文献.
- 要突出经历SG的CKD患者独特的代谢,营养和心理社会需求.
- 强调量身定制的后SG管理的重要性,以改善移植候选人和结果.
主要方法:
- 文献综述和综合现有关于慢性病患者减肥手术的研究.
- 分析SG对代谢参数,骨和肌肉健康以及CKD的心理社会因素的影响.
- 确定患者选择和术后护理的具体考虑因素.
主要成果:
- 袖子胃切除术对于患有晚期CKD的肥胖患者来说是安全有效的,有助于移植. 然而,存在肌肉和骨代谢的风险.
- 慢性病患者 (4-5D阶段) 具有独特的营养,代谢和心理社会需求,与一般腹手术患者不同.
- 专注于持续的代谢益处和最小化副作用的多学科护理对于优化移植等候名单上的健康至关重要.
结论:
- 精心选择SG候选人是必不可少的,以及全面的,多学科的术后管理,以适应CKD患者的特定需求.
- 解决肉症,骨代谢和心理社会因素对于改善整体健康和增加成功移植的可能性至关重要.
- 需要进一步的临床研究来探索这种复杂的患者群体的新型治疗方法.
相关概念视频
Chronic Pancreatitis II: Collaborative Care
88
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
88
Peptic Ulcer Disease V: Surgical Management and Nursing Care
303
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
303
Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
132
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
132


