急诊剖腹术。

Emergency Laparotomy.

机构信息

Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK.

Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Surgical Outcomes Research Centre, University College London, London, UK.

出版信息

Anesthesiol Clin. 2022 Mar;40(1):199-211. doi: 10.1016/j.anclin.2021.11.010.

DOI:10.1016/j.anclin.2021.11.010

PMID:35236580

Abstract

Emergency laparotomy is a high-risk surgical procedure with mortality and morbidity up to 10 times higher than for a similar procedure performed electively. An enhanced recovery approach has been shown to improve outcomes. A focus on rapid correction of underlying deranged acute physiology and proactive management of conditions associated with aging such as frailty and delirium are key. Patients are at high risk of complications and prevention and avoidance of failure to rescue are essential to improve outcomes. Other enhanced recovery components such as opioid-sparing analgesia and early postoperative mobilization are beneficial.

摘要

急诊剖腹手术是一种高风险的外科手术，其死亡率和发病率比类似的择期手术高 10 倍。强化恢复方法已被证明可以改善结果。重点是快速纠正基础紊乱的急性生理学，并积极管理与衰老相关的疾病，如虚弱和谵妄，这是关键。患者有发生并发症的高风险，预防和避免救援失败对于改善结果至关重要。其他强化恢复成分，如阿片类药物节约镇痛和早期术后活动，也是有益的。