在复杂的儿科关节和脊椎手术中进行外科期营养优化:系统性审查
Cameron Nosrat1, Youssef Sibih, Adrian Vallejo
1Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA.
接受复杂的骨科手术的儿科患者从营养优化中受益. 体重不足状态和体重减轻是关键的风险指标,而手术后增强恢复 (ERAS) 协议显示有望改善结果.
科学领域:
- 儿科整形医生 儿科整形医生
- 营养科学 营养科学
- 外科手术的结果
背景情况:
- 儿科复杂的关节和脊椎手术,特别是脑患者,并发症率很高.
- 在这个人群中,营养不良很普遍,对伤口愈合,感染风险和恢复产生负面影响.
- 不一致的营养不良的定义和评估阻碍了有效的术后营养管理.
研究的目的:
- 系统地审查有关术后营养评估和优化策略的文献.
- 确定营养不良的可靠指标,并评估营养干预措施在儿科整形外科手术的影响.
主要方法:
- 对MEDLINE,Embase和Cochrane数据库进行了符合PRISMA的系统审查.
- 研究包括接受关节或脊椎手术的儿科患者 (≤21岁),报告营养状况或干预措施.
- 对符合条件的RCT,队列研究和病例系列进行了数据提取和质量评估 (纽卡斯尔-太华尺度).
主要成果:
- 23项研究符合纳入标准;大多数是中等到高质量的回顾性队列.
- 实验室标记物显示出不一致的预测值,但基于BMI的指标和显著的体重减轻更好地预测了并发症.
- 手术后增强恢复 (ERAS) 协议显示在停留时间 (LOS),疼痛和炎症标志物的改善.
结论:
- 体重不足状态和体重减轻是儿童骨科手术中比孤立的实验室值更可靠的风险指标.
- 综合营养策略的ERAS协议显示了改善手术结果的潜力,尽管儿科专用数据有限.
- 标准化的营养查和干预评估对于接受复杂的骨科手术的高风险儿科患者群体至关重要.
更多相关视频
08:34Optimizing Minimally Invasive Spine Surgery: A Fully 3D CT O-Arm Navigated Workflow in MIS TLIF
Published on: October 17, 2025
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
相关概念视频
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Peripheral Artery Disease V: Postoperative Nursing Management
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Urinary Tract Calculi IV: Nutrition Therapy and Prevention
Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
