摘要
影响围术期食管胃手术吻合口瘘发生的危险因素:营养不良、吸烟、应用类固醇类药物、肠道准备、化学治疗、手术时间、使用升压药物、静脉输液管理、输血以及手术吻合技术等,提高外科医生识别吻合口瘘高风险患者的能力可尽量减少并发症发生。本文总结了针对这些危险因素具体措施:对营养不良者术前给予5~7 d改善免疫的营养治疗、充分的肠道准备、围术期戒烟、限制应用类固醇和升压药物、避免化疗后4周内手术及运用目标导向的液体管理。
The risk factors of esophagogastric anastomotic leak in the perioperative period include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, vasopressor drugs use, intravenous fluid administration, blood transfusion and surgical anastomotic technique, which can be reduced with the improvement of surgeons＇ ability to identify the high-risk patients. This article summarizes the specific measures for these risk factors： preoperative nutritional support for 5-7 d for malnourished patients, full intestinal preparation, perioperative smoking cessation, limitation of steroids and vasopressors drug applications, avoidance of early operations （〈4 weeks） following chemotherapy, and the goal-directed fluid management.
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2017年第6期475-479,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
吻合口瘘
围术期
影响因素
并发症
Anastomotic leak
periopeative period
influence factors
complications
