Im Gene Y, Lubezky Nir, Facciuto Marcelo E, Schiano Thomas D
Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, Recanati/Miller Transplantation Institute, One Gustave Levy Place, Box 1104, New York, NY 10029-6574, USA.
Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, Recanati/Miller Transplantation Institute, One Gustave Levy Place, Box 1104, New York, NY 10029-6574, USA.
Clin Liver Dis. 2014 May;18(2):477-505. doi: 10.1016/j.cld.2014.01.006. Epub 2014 Feb 25.
Patients with liver disease and portal hypertension are at increased risk of complications from surgery. Recent advances have allowed better optimization of patients with cirrhosis before surgery and a reduction in postoperative complications. Despite this progress, the estimation of surgical risk in a patient with cirrhosis is challenging. The MELD score has shown promise in predicting postoperative mortality compared with the Child-Turcotte-Pugh score. This article addresses current concepts in the perioperative evaluation of patients with liver disease and portal tension, including a preoperative liver assessment (POLA) checklist that may be useful towards mitigating perioperative complications.
患有肝病和门静脉高压症的患者手术并发症风险增加。最近的进展使得肝硬化患者在手术前能得到更好的优化，并减少术后并发症。尽管取得了这一进展，但评估肝硬化患者的手术风险仍具有挑战性。与Child-Turcotte-Pugh评分相比，终末期肝病模型（MELD）评分在预测术后死亡率方面已显示出前景。本文阐述了肝病和门静脉高压患者围手术期评估的当前概念，包括一份术前肝脏评估（POLA）清单，这可能有助于减少围手术期并发症。
