在肝切除后,E-AHPBA - ESSO - Innsbruck就术前和术后管理的共识建议提出了建议
Eva Maier1, Stefan Stättner2, Lucia Carrion-Alvarez3
1Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
概括
这份欧洲共识提供了基于证据的指导,用于优化肝脏外科手术中的术后护理. 关键建议包括预康复,动员和解决证据缺口,以改善肝切除术后患者的治疗结果.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 由于患者的因素,疾病特征和肝功能,肝脏手术存在重大并发症风险.
- 肝脏外科手术中的外科护理需要基于证据的指导来减轻这些风险.
研究的目的:
- 提供基于欧洲共识的指导,对肝脏外科手术的术后护理的选择方面提供指导.
- 解决包括血栓预防,抗生素,预康复,胆汁泄漏,出血和肝功能衰竭在内的关键话题.
主要方法:
- 采用了经过修改的Delphi流程,达成70%的协议门.
- 在主要数据库 (PubMed,EMBASE,Web of Science,Cochrane) 中进行了系统的文献搜索.
- 证据评估和陈述开发遵循了苏格兰大学间指南网络的方法.
主要成果:
- 从包括的204个出版物中制定了32个陈述,中位数证据水平为2.
- 强烈建议进行预康复,动员,避免常规排水.
- 对血栓预防和肝切除术后肝功能衰竭 (PHLF) 管理的证据最弱,突出了证据差距.
结论:
- 在肝切除术后优化术后护理仍然是一个挑战.
- 标准化关键实践和开展合作研究对于改善肝脏手术结果至关重要.
- 解决发现的证据缺口对于推进患者护理至关重要.
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