基于证据的外科灌流体管理框架和在流体短缺期间内镜病例优先级
Kevin Koo1, Meghan A Cooper1, Derek J Lomas1
1Department of Urology, Mayo Clinic, Rochester, Minnesota.
Urology practice
|January 29, 2025
概括
手术灌流体短缺需要保护. 像前列腺核切除这样的大量泌尿器科手术消耗大量的液体;优先考虑的框架平衡了液体使用和紧迫性,以有效地管理短缺.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术创新 在外科创新.
- 医疗保健管理的管理
背景情况:
- 美国2024年9月手术灌液供应中断突出了关键的保护需求.
- 由于流体短缺,可能推迟泌尿外科手术变得必要.
研究的目的:
- 在常见的内镜泌尿外科手术中描述液体的使用情况.
- 制定灌流体管理和在短缺期间优先考虑案件的建议.
主要方法:
- 审查的病例数量和灌液的使用,用于内镜尿道手术 (2024年1月至9月).
- 召集了一个由大量泌尿科医生组成的小组,使用修改后的Delphi方法达成共识.
- 按流体消耗和临床紧急情况分层分层的程序,以创建优先级框架.
主要成果:
- 在17%的病例中,四种手术 (前列腺核切除,前列腺穿尿管切除,皮肤性腎石切除,机器人喷水前列腺切除) 占总流体使用量的42%.
- 建立了一个五级优先级框架,先推迟优先级较低,流体使用量较高的案例.
- 针对患者和实习生需求,定义了四个流动管理原则.
结论:
- 四种最需要大量液体的内镜泌尿器科手术消耗了不成比例的外科灌液 (42%).
- 综合流体消耗和临床紧急情况的病例优先级框架有助于泌尿器科实践管理潜在的延期.
- 实施流体管理原则可以优化保护并最大限度地减少对患者和学员的不良影响.
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