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匿名使用者 發問時間: 社會與文化語言 · 5 年前

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DOES THE CHOICE OF FLUID MATTER IN MAJOR SURGERY?

INTRODUCTION

Numerous preparations of intravenous (IV) fluid are available for the replacement of perioperative fluid losses in patients undergoing major surgery. The selection of a specific fluid may be influenced by multiple factors, such as availability, cost, and tradition. Of late, attention has focused on the possible systemic effects of the various fluid preparations. Additionally, there is awareness that particular fluids may not only influence clinical variables during the intraoperative period but may also affect postoperative outcome. Clinicians’ choice of fluid replacement therapy for patients undergoing major surgical procedures is increasingly influenced by the beneficial or detrimental effects of IV fluids, independent of their efficacy as blood volume expanders.

Many clinical and experimental studies have been carried out to determine the potential clinical effects of IV fluids. Unfortunately, there is a paucity of large, prospective, randomized, blinded clinical studies of the effects of the intraoperative administration of IV fluids on clinical outcomes, despite the fact that approximately 3 million major surgical procedures are performed annually in the United States alone. However, multiple outcomes have been examined in small investigations in numerous and diverse patient populations and in studies of healthy volunteers.

In addition to the fluids themselves, a separate body of literature has looked at the way in which these fluids are administered. Fluid studies are often labeled restrictive, liberal, or goal directed. Goal-directed fluid therapy is a term that relates to the use of an algorithm to guide administration of fluids to optimize homodynamic status.

1 個解答

評分
  • Chris
    Lv 7
    5 年前
    最佳解答

    輸液的選擇對重大手術重要嗎?

    導言

    很多靜脈輸液可以替補進行重大手術的病人在手術中體液的流失 輸液的選擇可能受多種因素的影響 例如便利性 價格以及慣例 近來注意力已經著重於各種不同輸液對全身系統的影響 進一步也注意到特定的輸液可能不止影響手術期間的臨床變化 也可能影響手術之後的結果 醫師為進行重大手術病人的輸液療法做選擇時 除了其擴充血流量的功效 受到靜脈輸液的有利或不利效果的影響大為增加

    關於確定靜脈輸液的潛在效果 已經有許多臨床及實驗的研究在進行 可惜的是 關於手術施行靜脈輸液對臨床後果的影響卻缺乏大型有展望隨機盲測的臨床研究 雖然單單美國每年就有約3百萬件重大手術施行 然而 在對許多及不同類病患所做的小型調查和對健康志願者的研究中 多種後果已經調查出來了

    除了輸液本身 也有另外的文獻關注於輸液施行的方式 輸液研究經常標示為限制的 開放的 或目標導向的 目標導向輸液療法是一個專有名稱 與使用一種運算來指導輸液的施行以達完美的血行狀態相關

    以上供參

    PS 希望你可以自選解答 這個英文版廣告橫行 努力的回答經常被他們的投票部隊霸凌 所以回答意願越來越少

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