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Array ( [id] => 690 [catid] => 26 [title] => 中国加速康复外科临床实践指南(2021):(二) 肝胆外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/690.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 术前根据Caprini模型评估病人血栓风险,根据PVT的风险因素,个体化制定预防术后门静脉血栓的方案。(证据等级:高;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
术前根据Caprini模型评估病人血栓风险,根据PVT的风险因素,个体化制定预防术后门静脉血栓的方案。(证据等级:高;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 691 [catid] => 38 [title] => 中国加速康复外科临床实践指南(2021):(二) 肝胆外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/691.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 根据手术方式和术中具体情况决定是否留置腹腔引流管,术后若无胆漏、出血等并发症,宜尽早拔除。不常规留置胃管,若有特殊情况需留置,建议在麻醉清醒前拔除。术后尽早拔除尿管,无须常规进行膀胱锻炼。(证据等级:低;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
根据手术方式和术中具体情况决定是否留置腹腔引流管,术后若无胆漏、出血等并发症,宜尽早拔除。不常规留置胃管,若有特殊情况需留置,建议在麻醉清醒前拔除。术后尽早拔除尿管,无须常规进行膀胱锻炼。(证据等级:低;推荐强度:一般性推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 692 [catid] => 26 [title] => 中国加速康复外科临床实践指南(2021):(二) 肝胆外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/692.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 1 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 通过术前精准评估、术中精细操作、积极病因治疗等措施预防肝胆外科手术后肝功能不全;应充分引流术后胆漏,必要时留置内镜支架;腹腔积液病人未出现感染征象时,不建议行单纯腹腔积液穿刺引流。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
通过术前精准评估、术中精细操作、积极病因治疗等措施预防肝胆外科手术后肝功能不全;应充分引流术后胆漏,必要时留置内镜支架;腹腔积液病人未出现感染征象时,不建议行单纯腹腔积液穿刺引流。(证据等级:中;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 693 [catid] => 38 [title] => 中国加速康复外科临床实践指南(2021):(二) 肝胆外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/693.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 综合评估病人术后情况,制定合理的出院标准和随访机制。(证据等级:低;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
综合评估病人术后情况,制定合理的出院标准和随访机制。(证据等级:低;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 694 [catid] => 25 [title] => 中国加速康复外科临床实践指南(2021):(三) 胰腺外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/694.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://oss.wanfangdata.com.cn/Catalog/List?fileId=perio_xhyx202105008&transaction=%7B%22id%22%3Anull%2C%22transferOutAccountsStatus%22%3Anull%2C%22transaction%22%3A%7B%22id%22%3A%221742893616742813696%22%2C%22status%22%3A1%2C%22createDateTime%22%3Anull%2C%22payDateTime%22%3A1704373194286%2C%22authToken%22%3A%22TGT-1929509-TzWB1uckL6uKPjmvOgnI4JFWbSoLwo5RB0fYFakbnMDHGqXcLe-auth-iploginservice-8584c6d4cc-25wpl%22%2C%22user%22%3A%7B%22accountType%22%3A%22Group%22%2C%22key%22%3A%22ldxysy%22%7D%2C%22transferIn%22%3A%7B%22accountType%22%3A%22Income%22%2C%22key%22%3A%22PeriodicalFulltext%22%7D%2C%22transferOut%22%3A%7B%22GTimeLimit.ldxysy%22%3A3.0%7D%2C%22turnover%22%3A3.0%2C%22orderTurnover%22%3A3.0%2C%22productDetail%22%3A%22perio_xhyx202105008%22%2C%22productTitle%22%3Anull%2C%22userIP%22%3A%22117.157.14.84%22%2C%22organName%22%3Anull%2C%22memo%22%3Anull%2C%22orderUser%22%3A%22ldxysy%22%2C%22orderChannel%22%3A%22pc%22%2C%22payTag%22%3A%22%22%2C%22webTransactionRequest%22%3Anull%2C%22signature%22%3A%22PMtTap5W%2FM287R4DjyRGpyhxlkOwKBvJsS5VOSWYPq02Xl2eh6MWTzJrZiSlbK5lz5fAkfccz%2FC6%5Cn7U09U8pZG7C51CjoYwOpZZqhN9zfU6HBFl1U47us9ENpiJEoMR5EjCa4okVI314OP1GmY18OPA%2FE%5CngfUVR6Hz3b0DLOIKtAY%3D%22%7D%2C%22isCache%22%3Afalse%7D [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 术前宣教、医患沟通应作为常规项目开展,且应贯穿围手术期的整个过程直至病人出院。(证据等级:低;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
术前宣教、医患沟通应作为常规项目开展,且应贯穿围手术期的整个过程直至病人出院。(证据等级:低;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 695 [catid] => 26 [title] => 中国加速康复外科临床实践指南(2021):(三) 胰腺外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/695.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 胰腺肿瘤病人术前应常规进行MDT讨论,制定最为合理的围手术期综合治疗措施。(证据等级:低;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰腺肿瘤病人术前应常规进行MDT讨论,制定最为合理的围手术期综合治疗措施。(证据等级:低;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 696 [catid] => 38 [title] => 中国加速康复外科临床实践指南(2021):(三) 胰腺外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/696.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 术前3~6周开始预康复,有助于改善功能状态并减少术后并发症。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
术前3~6周开始预康复,有助于改善功能状态并减少术后并发症。(证据等级:中;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 697 [catid] => 26 [title] => 中国加速康复外科临床实践指南(2021):(三) 胰腺外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/697.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 梗阻性黄疸合并发热及胆管炎等感染表现或行新辅助治疗前,应行术前胆管引流;黄疸严重病人(血胆红素水平>250μmol/L)术前是否胆管引流应进行MDT讨论综合判断。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
梗阻性黄疸合并发热及胆管炎等感染表现或行新辅助治疗前,应行术前胆管引流;黄疸严重病人(血胆红素水平>250μmol/L)术前是否胆管引流应进行MDT讨论综合判断。(证据等级:中;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 698 [catid] => 26 [title] => 中国加速康复外科临床实践指南(2021):(三) 胰腺外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/698.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 术前应采用NRS2002对所有病人进行营养风险筛查,对营养不良病人行营养支持治疗,首选肠内营养。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
术前应采用NRS2002对所有病人进行营养风险筛查,对营养不良病人行营养支持治疗,首选肠内营养。(证据等级:中;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读
Array ( [id] => 699 [catid] => 266 [title] => 中国加速康复外科临床实践指南(2021):(三) 胰腺外科手术部分 [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => https://www.anes-guide.com/show/699.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:25 [updatetime] => 2024-01-11 15:13:25 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2021 [guojia] => 中华医学会外科学分会;中华医学会麻醉学分会 [pdf] => [tjyjyw] => [lyyw] => [laiyuan] => 胰十二指肠切除术术前不需常规行机械性肠道准备。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰十二指肠切除术术前不需常规行机械性肠道准备。(证据等级:中;推荐强度:强推荐)

证据评价方法:GRADE

指南质量等级:C

年份:2021

国家:中华医学会外科学分会;中华医学会麻醉学分会

阅读