手术后简化增强恢复手术内流体管理手术内流体管理
Hilary Gallin1, Marcus V Ortega2, Rachel Sisodia3
1Department of Anesthesiology, Weill Cornell School of Medicine, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
The Journal of surgical research
|February 15, 2025
概括
在手术后增强恢复 (ERAS) 途径中,简化的500毫升/小时的液体度量有效地改善了手术后的功能. 这种平衡的方法可以降低过度水分的风险,同时确保足够的水分,从而改善患者的治疗结果.
科学领域:
- 麻醉学和外科手术期间的医学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术重症监护手术重症监护
背景情况:
- 手术后增强恢复 (ERAS) 途径旨在优化患者的康复.
- 术后流体管理对于术后的结果至关重要,特别是功能.
- 目前的液体施用方法可能缺乏标准化,可能导致低于最佳水分或过度水分.
研究的目的:
- 为了评估ERAS途径中简化的手术内液体管理指标 (500毫升/小时) 的有效性.
- 为了确定这个指标是否优化了流体管理和改善了手术后的功能.
- 评估该指标对手术后血清肌水平的影响.
主要方法:
- 在ERAS途径中,对1028名经过重大腹部手术 (子宫切除术,大肠切除术,胃切除术) 的成年患者进行了回顾性评估.
- 拟议的流体指标 (500毫升/小时) 与传统的流体输送方法的比较.
- 分析血清肌素变化和监测遵守简化流体指标,使用统计测试,包括定量回归.
主要成果:
- 接受液体体积低于最佳范围的患者显示,血清肌氨酸的中位数增加为0.03 mg/dL.
- 接受超过最佳范围的液体体积的患者显示,血清肌氨酸的中位数增加为0.01 mg/dL.
- 简化流体指标表明了平衡的流体管理方法.
结论:
- 在ERAS途径中,简化流体度量500毫升/小时有效改善术后功能.
- 这一指标平衡了水分,减少了过度水分的风险,并促进了对流体的遵守.
- 拟议的指标提供了一种实用,基于证据的方法,用于在各种医疗机构为接受ERAS程序的患者提供液体.
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