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本文引用的文献

1
The role of acute in-patient rehabilitation on short-term outcomes after liver transplantation: A systematic review of the literature and expert panel recommendations.肝移植术后短期结局中急性住院康复的作用:文献系统评价和专家小组建议。
Clin Transplant. 2022 Sep;36(9):e14706. doi: 10.1111/ctr.14706.
2
Randomized Clinical Study of Temporary Transvenous Phrenic Nerve Stimulation in Difficult-to-Wean Patients.临时经静脉膈神经刺激用于撤机困难患者的随机临床研究
Am J Respir Crit Care Med. 2022 May 15;205(10):1169-1178. doi: 10.1164/rccm.202107-1709OC.
3
Enhanced recovery after surgery programs improve short-term outcomes after liver transplantation-A systematic review and meta-analysis.手术康复促进计划可改善肝移植术后的短期转归:系统评价和荟萃分析。
Clin Transplant. 2021 Nov;35(11):e14453. doi: 10.1111/ctr.14453. Epub 2021 Sep 16.
4
Low yield of head CT in cirrhotic patients presenting with hepatic encephalopathy.肝硬化伴肝性脑病患者行头部 CT 检查的阳性率低。
BMJ Open Gastroenterol. 2021 Jun;8(1). doi: 10.1136/bmjgast-2021-000609.
5
Guidelines for Perioperative Care for Liver Transplantation: Enhanced Recovery After Surgery (ERAS) Recommendations.肝移植围手术期护理指南:术后加速康复(ERAS)建议
Transplantation. 2022 Mar 1;106(3):552-561. doi: 10.1097/TP.0000000000003808.
6
The 6-Minute Walk Test Distance Predicts Mortality in Cirrhosis: A Cohort of 694 Patients Awaiting Liver Transplantation.6分钟步行试验距离可预测肝硬化患者的死亡率:一项对694例等待肝移植患者的队列研究
Liver Transpl. 2021 Oct;27(10):1490-1492. doi: 10.1002/lt.26087. Epub 2021 Jul 31.
7
Frailty as a predictive factor for survival after liver transplantation, especially for patients with MELD≤15-a prospective study.衰弱作为肝移植后生存的预测因素,特别是对于 MELD≤15 的患者-一项前瞻性研究。
Langenbecks Arch Surg. 2021 Sep;406(6):1963-1969. doi: 10.1007/s00423-021-02109-9. Epub 2021 Apr 13.
8
Physiologic Reserve Assessment and Application in Clinical and Research Settings in Liver Transplantation.生理储备评估及其在肝移植临床和研究中的应用。
Liver Transpl. 2021 Jul;27(7):1041-1053. doi: 10.1002/lt.26052.
9
Pre-transplant Sarcopenic Obesity Worsens the Survival After Liver Transplantation: A Meta-Analysis and a Systematic Review.肝移植前肌少症性肥胖会降低肝移植后的生存率:一项荟萃分析和系统评价
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10
Inspiratory Muscle Training With an Electronic Resistive Loading Device Improves Prolonged Weaning Outcomes in a Randomized Controlled Trial.电子阻力加载装置的吸气肌训练可改善随机对照试验中延长撤机结局。
Crit Care Med. 2021 Apr 1;49(4):589-597. doi: 10.1097/CCM.0000000000004787.

急性慢性肝衰竭肝移植围手术期评估与康复专家共识

Expert consensus on liver transplantation perioperative evaluation and rehabilitation for acute-on-chronic liver failure.

作者信息

Lv Haijin, Zheng Haiqing, Liu Jianrong, Cai Qing, Ren Yuji, Yi Huimin, Yang Yang, Hu Xiquan, Chen Guihua

机构信息

Surgical Intensive Care Unit, Intensive Care Unit of Organ Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

Liver Res. 2022 Aug 18;6(3):121-129. doi: 10.1016/j.livres.2022.08.002. eCollection 2022 Sep.

DOI:10.1016/j.livres.2022.08.002
PMID:39958201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11791836/
Abstract

Acute-on-chronic liver failure (ACLF) can be cured by liver transplantation; however, perioperative complications still affect posttransplant outcomes. In recent years, early rehabilitation for critical illness, liver disease, and surgery have significantly improved organ reserve function, surgery tolerance, and postoperative quality of life. They could also be applied in the perioperative period of liver transplantation in patients with ACLF. Therefore, the Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association, the Organ Transplant Committee of China Association Rehabilitation Medicine, and the Guangdong Medical Doctor Association of Organ Transplantation conducted a comprehensive review of rehabilitation in end-stage liver disease, critical illness and surgical patients by summarizing current evidence and best clinical practices and proposed a practice consensus on evaluation of cardiopulmonary and physical function, rehabilitation or physiotherapies, as well as the safety concerns in perioperative liver transplant recipients. It will be a valuable resource for hepatologists, transplant surgeons, and intensivists as they care for ACLF patients during transplantation.

摘要

急性慢性肝衰竭(ACLF)可通过肝移植治愈;然而,围手术期并发症仍会影响移植后的结局。近年来,针对危重症、肝脏疾病及手术的早期康复显著改善了器官储备功能、手术耐受性及术后生活质量。这些康复措施也可应用于ACLF患者肝移植的围手术期。因此,中华医学会器官移植分会移植免疫委员会、中国康复医学会器官移植委员会及广东省医师协会器官移植分会通过总结现有证据及最佳临床实践,对终末期肝病、危重症及手术患者的康复进行了全面综述,并就心肺和身体功能评估、康复或物理治疗以及肝移植围手术期受者的安全问题提出了实践共识。这将为肝病学家、移植外科医生及重症监护医生在肝移植期间护理ACLF患者提供宝贵资源。