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Array ( [id] => 700 [catid] => 28 [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/700.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] => 术前禁食有必要性,麻醉实施前应予足够的胃排空时间。术前服用碳水化合物饮料有助于病人康复,但在胃肠道动力不足或消化道梗阻者应审慎应用。(证据等级:中;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
术前禁食有必要性,麻醉实施前应予足够的胃排空时间。术前服用碳水化合物饮料有助于病人康复,但在胃肠道动力不足或消化道梗阻者应审慎应用。(证据等级:中;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] => 701 [catid] => 29 [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/701.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] => 胰腺外科手术应常规在全身麻醉下完成,对于开放性手术可联合硬膜外或周围神经阻滞,术中应加强血流动力学监测,术后注意防治硬膜外镇痛的不良反应。(证据等级:中;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰腺外科手术应常规在全身麻醉下完成,对于开放性手术可联合硬膜外或周围神经阻滞,术中应加强血流动力学监测,术后注意防治硬膜外镇痛的不良反应。(证据等级:中;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] => 702 [catid] => 32 [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/702.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] => 采用以目标为导向的液体治疗理念,避免术中容量不足或容量负荷过重。平衡盐溶液优于生理盐水。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
采用以目标为导向的液体治疗理念,避免术中容量不足或容量负荷过重。平衡盐溶液优于生理盐水。(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] => 703 [catid] => 35 [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/703.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] => 胰腺外科术后首选硬膜外镇痛;无硬膜外镇痛病人建议采用联合周围神经阻滞或切口浸润和全身阿片类药物、非阿片类药物的多模式镇痛方案。(证据等级:高;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰腺外科术后首选硬膜外镇痛;无硬膜外镇痛病人建议采用联合周围神经阻滞或切口浸润和全身阿片类药物、非阿片类药物的多模式镇痛方案。(证据等级:高;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] => 704 [catid] => 37 [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/704.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] => 围手术期采用合理的措施预防术后恶心呕吐。高危病人(>3种危险因素)应采取多模式预防术后恶心呕吐方案。 (证据等级:低;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
围手术期采用合理的措施预防术后恶心呕吐。高危病人(>3种危险因素)应采取多模式预防术后恶心呕吐方案。 (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] => 705 [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/705.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后不常规留置鼻胃管。(证据等级:中;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰十二指肠切除术术后不常规留置鼻胃管。(证据等级:中;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] => 706 [catid] => 39 [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/706.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] => 不推荐胰十二指肠切除术术后常规使用生长抑素及类似物预防胰瘘。但对FRS中等风险以上的病人,建议预防性应用。(证据等级:中;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
不推荐胰十二指肠切除术术后常规使用生长抑素及类似物预防胰瘘。但对FRS中等风险以上的病人,建议预防性应用。(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] => 707 [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/707.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后应常规放置腹腔引流管,可视引流物性状、流量及淀粉酶测定值早期拔除。(证据等级:中;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰十二指肠切除术术后应常规放置腹腔引流管,可视引流物性状、流量及淀粉酶测定值早期拔除。(证据等级:中;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] => 708 [catid] => 36 [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/708.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] => 无预防胰十二指肠切除术术后胃排空延迟的明确措施。应用硬膜外麻醉、维持液体出入量平衡、早期进食有助于术后肠功能的恢复。针对相关危险因素,适当应用干预手段,尤其是减少胰瘘、腹腔感染等并发症有助于降低胃排空延迟的发生率。(证据等级:低;推荐强度:强推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
无预防胰十二指肠切除术术后胃排空延迟的明确措施。应用硬膜外麻醉、维持液体出入量平衡、早期进食有助于术后肠功能的恢复。针对相关危险因素,适当应用干预手段,尤其是减少胰瘘、腹腔感染等并发症有助于降低胃排空延迟的发生率。(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] => 709 [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/709.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后营养管理须结合术前营养状态及术中、术后并发症等情况酌定。推荐早期进食,根据营养达标、病人耐受及并发症严重程度,选择经口进食、肠内或肠外营养。(证据等级:中;推荐强度:一般性推荐) [znzldj] => C [_inputtime] => 1704957205 [_updatetime] => 1704957205 [_nrjc] => [_nrsh] => )
推荐意见
胰十二指肠切除术术后营养管理须结合术前营养状态及术中、术后并发症等情况酌定。推荐早期进食,根据营养达标、病人耐受及并发症严重程度,选择经口进食、肠内或肠外营养。(证据等级:中;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