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结直肠手术患者的麻醉与围手术期管理——特殊问题(第2部分)

Anesthesia and perioperative management of colorectal surgical patients - specific issues (part 2).

作者信息

Patel Santosh, Lutz Jan M, Panchagnula Umakanth, Bansal Sujesh

机构信息

Department of Anesthesia, The Pennine Acute NHS Trust, Rochdale and Honorary Lecturer, School of Biomedicine, University of Manchester, United Kingdom.

出版信息

J Anaesthesiol Clin Pharmacol. 2012 Jul;28(3):304-13. doi: 10.4103/0970-9185.98321.

Abstract

Colorectal surgery carries significant morbidity and mortality, which is associated with an enormous use of healthcare resources. Patients with pre-existing morbidities, and those undergoing emergency colorectal surgery due to complications such as perforation, obstruction, or ischemia / infarction are at an increased risk for adverse outcomes. Fluid therapy in emergency colorectal surgical patients can be challenging as hypovolemic and septic shock may coexist. Abdominal sepsis is a serious complication and may be diagnosed during pre-, intra-, or postoperative periods. Early suspicion and recognition of medical and / or surgical complications are essential. The critical care management of complicated colorectal surgical patients require collaborative and multidisciplinary efforts.

摘要

结直肠手术具有较高的发病率和死亡率,这与大量医疗资源的使用相关。患有基础疾病的患者,以及因穿孔、梗阻或缺血/梗死等并发症而接受急诊结直肠手术的患者,出现不良结局的风险增加。急诊结直肠手术患者的液体治疗具有挑战性,因为低血容量性休克和感染性休克可能同时存在。腹部感染是一种严重的并发症,可能在术前、术中或术后被诊断出来。早期怀疑并识别医疗和/或手术并发症至关重要。复杂结直肠手术患者的重症监护管理需要多学科的协作努力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e635/3409937/e6a42ae5e752/JOACP-28-304-g001.jpg

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