Puppo Moreno A M, Abella Alvarez A, Morales Conde S, Pérez Flecha M, García Ureña M Á
Servicio de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, España.
Servicio de Cuidados Intensivos, Hospital Universitario Henares, Madrid, España.
Med Intensiva (Engl Ed). 2019 Dec;43(9):569-577. doi: 10.1016/j.medin.2019.05.007. Epub 2019 Aug 1.
Despite low mortality in patients undergoing major abdominal surgery, the number of high-risk patients is increasing and has become a health problem. At present, surgery is understood as a continuous process, in which numerous guidelines added to less invasive techniques offering a lesser physiological impact upon patients with serious comorbidities are responsible for the final outcome. The prevention, identification and early treatment of complications prove as important as the preoperative or surgical technique.?The introduction of ERAS (enhanced recovery after surgery) protocols is the cornerstone for the management of these patients, and is advocated by most surgical societies for reducing mortality, length of hospital stay and hospital costs. The postoperative management of these patients in postsurgery Intensive Care Units guarantees effectiveness and efficiency in maintaining optimum patient care.
尽管接受腹部大手术的患者死亡率较低,但高危患者的数量正在增加,并已成为一个健康问题。目前,手术被理解为一个连续的过程,在这个过程中,众多指南加上侵入性较小的技术,对患有严重合并症的患者生理影响较小,这些因素共同决定了最终结果。并发症的预防、识别和早期治疗与术前或手术技术同样重要。引入加速康复外科(ERAS)方案是管理这些患者的基石,大多数外科学会都主张采用该方案以降低死亡率、缩短住院时间和降低医院成本。在术后重症监护病房对这些患者进行术后管理,可确保在维持最佳患者护理方面的有效性和效率。