深夜肝移植对接受者结果的影响
Isis Carton1,2, Estelle Le Pabic3, Alexandre Thobie4,5
1Department of Hepatobiliary and Digestive Surgery, Rennes University Hospital, University of Rennes 1, Rennes, France. isis.carton@hotmail.fr.
Updates in surgery
|October 9, 2024
概括
在夜间进行肝移植时,员工的警觉性可能会降低,这与严重的术后并发症的增加有关. 建议重新考虑手术安排,并探索延长移植保存方法,以改善患者的治疗结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 医疗组织 医疗组织
背景情况:
- 肝移植是末期肝病的关键手术.
- 移植采购往往发生迟,导致夜间移植手术.
- 在夜间手术过程中警觉性降低可能会影响患者的安全.
研究的目的:
- 调查夜间肝移植与严重的术后并发症之间的关联.
- 评估深夜手术对90天内患者结果的影响.
主要方法:
- 在2012年至2018年间,对790例肝移植进行了观察性研究.
- 在夜间手术 (午夜-5点) 和对照组之间的结果比较.
- 多变量分析调整为冷缺血时间.
主要成果:
- 夜间的肝移植需要更多的输血 (P=0.010).
- 在90天内观察到更高的严重Clavien-Dindo ≥IIIb并发症的几率 (OR 1.67;95% CI [1.10-2.54]).
- 两组之间的一年移植和患者存活率相似.
结论:
- 应该重新考虑肝移植手术的安排,以尽量减少夜间手术.
- 可能需要专门的夜间团队或延长的移植保存 (例如机器 perfusion) 等策略.
- 优化手术时间可能会减少严重的术后并发症.
相关概念视频
Kidney Transplant II: Surgical Procedure
2
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
2
Kidney Transplant I: Introduction
2
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
2
Kidney Transplant III: Nursing Management
3
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
3


