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[腹部大手术围手术期的液体管理]

[Perioperative fluid management in major abdominal surgery].

作者信息

von der Forst M, Weiterer S, Dietrich M, Loos M, Lichtenstern C, Weigand M A, Siegler B H

机构信息

Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.

Klinik für Anästhesie und operative Intensivmedizin, Rheinland Klinikum Neuss/Lukaskrankenhaus, Preußenstraße 84, 41464, Neuss, Deutschland.

出版信息

Anaesthesist. 2021 Feb;70(2):127-143. doi: 10.1007/s00101-020-00867-7.

Abstract

Intravascular fluid administration belongs to the cornerstones of perioperative treatment with a substantial impact on surgical outcome especially with respect to major abdominal surgery. By avoidance of hypovolemia and hypervolemia, adequate perioperative fluid management significantly contributes to the reduction of insufficient tissue perfusion as a determinant of postoperative morbidity and mortality. The effective use of intravascular fluids requires detailed knowledge of the substances as well as measures to guide fluid therapy. Fluid management already starts preoperatively and should be continued in the postoperative setting (recovery room, peripheral ward) considering a patient-adjusted and surgery-adjusted hemodynamic monitoring. Communication between all team members participating in perioperative care is essential to optimize fluid management.

摘要

血管内液体输注是围手术期治疗的基石之一,对手术结果有重大影响,尤其是在腹部大手术方面。通过避免低血容量和高血容量,充分的围手术期液体管理显著有助于减少组织灌注不足,而组织灌注不足是术后发病率和死亡率的决定因素。有效地使用血管内液体需要详细了解相关物质以及指导液体治疗的措施。液体管理在术前就已开始,并且在术后环境(恢复室、普通病房)中应继续进行,同时要考虑根据患者和手术情况进行血流动力学监测。参与围手术期护理的所有团队成员之间的沟通对于优化液体管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4187/7851019/239b2e9cc904/101_2020_867_Fig1_HTML.jpg

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