经脏调整的ERAS®协议对经过部分切除术的患者的术后结果的影响
Margarete Teresa Walach1, Mona Körner2, Christel Weiß3
1Department of Urology and Urosurgery, Medical Faculty Mannheim, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. margarete.walach@umm.de.
Langenbeck's archives of surgery
|October 23, 2024
概括
经过脏调整的手术后增强恢复 (kERAS) 协议对经过脏节约手术 (PN) 后的长期脏功能产生积极影响. 这种方案可以安全地实施,而不会增加急性损伤 (AKI) 的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 节能手术 (PN) 对于保持功能至关重要.
- 手术后增强恢复 (ERAS) 协议优化了外科手术期间的护理.
- 开发了一个调整的ERAS (kERAS) 协议,专门针对PN期间的功能.
研究的目的:
- 评估KERAS协议在接受PN的患者中的疗效.
- 评估kERAS对急性损伤 (AKI),TRIFECTA标准的实现,慢性病 (CKD) 进展和住院时间 (LOS) 的影响.
主要方法:
- 一个潜在的队列 (n=147) 接受了kERAS协议,重点是液体/营养管理和血压控制.
- 一个回顾性队列 (n=162) 作为没有kERAS协议的对照组.
- 包括AKI,TRIFECTA,CKD升级/发病和LOS在内的结果在各组之间进行了比较.
主要成果:
- kERAS并没有显著降低术后AKI的发生率.
- 接受kERAS治疗的患者表现出TRIFECTA标准的改善 (OR2.2,p=0.0374).
- kERAS显著减少了长期的CKD升级阶段 (p=0.0033),但没有影响新的CKD发病或LOS.
结论:
- 该kERAS协议对PN后的长期功能产生了积极的影响.
- kERAS可以安全地实施,而不会增加AKI风险.
- 该协议的集成是可行的,可管理的额外的努力.
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