术后的流体限制,以预防内镜转形外科手术后的延迟低血症
Doriann Klassen1, Shinghei Mok2, Jenie Y Hwang2,3
1Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO, USA.
Neuro-oncology
|March 14, 2025
概括
在内镜内外科手术 (EETS) 后的液体限制显著降低了延迟低血和重入院的风险. 在预防严重的低血症方面,严格的液体限制比适度的限制或无限期的液体摄入更有效.
科学领域:
- 神经外科 神经外科
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 对于垂体神经内分泌瘤 (PitNETs) 和其它细胞病理,经过内镜内透膜外科手术 (EETS) 后的再入院往往与延迟的低血症有关.
- 手术后的流体限制 (FR) 假设可以缓解延迟的低血症.
- 这项研究前性地评估了EETS后FR的疗效.
研究的目的:
- 评估术后流体限制对EETS后延迟低血症发病率的影响.
- 为了比较严格与适度的流体限制对随意流体摄入的有效性.
- 评估FR对医院再入院率的影响.
主要方法:
- 一项前性随机受控研究,涉及300名接受EETS的参与者.
- 排除标准包括CKD,CHF和现有的低血或相关的内分泌疾病.
- 从手术后的第3天到第14天,参与者被分配到控制 (ad-lib),中度FR (1.8-2 L/day) 或严格FR (1-1.2 L/day) 中.
主要成果:
- 总体而言,低血的发病率为31.9% (对照组),28.2% (中度FR) 和21.0% (严格FR).
- 严重的低血发病率为7.4% (对照组),5.1% (中度FR) 和0% (严格FR).
- 与对照组相比,严格的FR组显示出较高的水平和明显较低的严重低血和再录取率.
结论:
- 手术后的流体限制明显减少了EETS后的延迟低血症和相关的再接收.
- 严格的液体限制似乎比适度的限制或随意摄入更有益.
- 需要进一步的研究来确定EETS后的最佳FR体积和持续时间.
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