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在E-AHPBA-ESSO-Innsbruck的共识中,就肝切除术后的术前和术后管理提出了建议
Eva Maier1, Stefan Stättner2,3, Lucia Carrion-Alvarez4
1Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
The British journal of surgery
|December 30, 2025
概括
优化肝脏手术护理是复杂的. 这份欧洲共识提供了基于证据的指导,介绍了外科手术期间的实践,强调了强有力的预康复和动员建议,同时确定了血栓预防和肝切除术后肝功能衰竭管理的证据缺口.
科学领域:
- 肝胆道手术 肝胆道手术
- 基于证据的医学基于证据的医学.
- 临床实践指南 临床实践指南
背景情况:
- 由于患者的因素,疾病和肝功能,肝脏手术具有很高的并发症风险.
- 专业知识对于管理肝胆病患者至关重要.
- 这一共识提供了基于证据的指导,关于外科手术期间的护理.
研究的目的:
- 制定基于证据的指导,针对肝脏外科手术中选择的术前和术后护理方面的指导.
- 解决肝切除后优化患者治疗结果的关键挑战.
主要方法:
- 经过修改的Delphi过程,达成70%的共识门.
- 专家小组包括外科医生,麻醉师,肝病学家,护士和理疗师.
- 在主要数据库中进行系统的文献搜索;使用SIGN方法进行证据评估.
主要成果:
- 从204个出版物中制定了32个陈述;中位数证据水平2.
- 术前血栓预防和肝切除术后肝功能衰竭 (PHLF) 管理的最弱证据.
- 强烈建议进行预康复,早期动员,避免常规排水;发现证据缺陷.
结论:
- 在切除肝脏后优化术前和术后护理仍然具有挑战性.
- 标准化关键实践对于改善患者治疗结果至关重要.
- 需要进行合作研究,以解决已识别的证据缺口.
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