在活着的脏捐赠者中,手术内流体管理和术后结果之间的关联:一个回顾性队列研究
Ja Eun Lee1, Chisong Chung1, Sunghae Park2
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Scientific reports
|January 25, 2025
概括
在腹腔镜供体切除术 (LDN) 中,自由性手术内液体的使用与更糟糕的结果有关. 避免低血症对于活体脏捐赠者的恢复和预防急性脏损伤至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 外科手术的结果
- 麻醉学 麻醉学
背景情况:
- 在腹腔镜供体切除术 (LDN) 中,最优的手术内流体管理尚未得到充分证实.
- 自由流体策略旨在确保移植 perfusion,但流体过载和不良结果的风险.
- 活着的脏捐赠者可能会出现与手术内流体平衡相关的并发症.
研究的目的:
- 根据不同的手术内晶体质输液速率来比较活着的脏捐赠者的术后结果.
- 为了研究手术内流体管理和脏切除术后的功能之间的关联.
- 确定流体策略,尽量减少LDN受体的不良事件.
主要方法:
- 六年来对505个LDN进行了回顾性分析.
- 根据手术内结晶体输液速率 (ml/kg/hr) 将捐赠者分为三层.
- 治疗权重与平衡的逆概率用于分析结果.
主要成果:
- 血清肌素 (sCr) 的最大升高在液体管理组之间没有显著差异.
- 较低的手术内流体率 (第一组) 与双倍的sCr增加 (急性损伤第二阶段) 和长时间住院的发病率较高有关.
- 达到最低sCr的时间在最低的液体输液组中最长.
结论:
- 低血症,以较低的手术内流体率为标志,与活着的脏捐赠者的手术后结果较差有关.
- 目前的自由流体管理策略可能需要重新评估,以优化捐赠者恢复.
- 需要进一步的研究,以建立最佳的流体管理协议为LDN.
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