[麻醉师在肝脏移植手术中的作用 - 术前评估]。

IF 0.3 4区 医学 Q4 ANESTHESIOLOGY
Markus Müller, Christian Grasshoff
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引用次数: 0

摘要

在列入肝移植手术(LT)名单之前,需要由包括外科医生、肝病专家和麻醉师在内的专业团队进行仔细的多学科术前评估,以改善短期和长期的临床效果。由于供体器官供应不足和人口结构的变化,列入肝移植名单的患者年龄越来越大、病情越来越重、合并症越来越多。由于心血管事件是早期死亡的主要原因,因此必须对风险因素进行精确评估。本综述重点关注等待接受低温截瘫治疗的患者中冠状动脉疾病、肝硬化心肌病、门肺动脉高压和肝肺综合征的检测和管理。此外,还对评分系统、急性慢性肝衰竭(ACLF)患者、虚弱、NASH 肝硬化以及药物滥用患者的心理评估等问题进行了深入探讨。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The Role of the Anaesthesiologist in Liver Transplantation - Preoperative Evaluation].

Preoperative evaluation prior to listing for orthotopic liver transplantation (LT) requires a careful multidisciplinary approach with specialized teams including surgeons, hepatologists and anesthesiologists in order to improve short- and long-term clinical outcomes. Due to inadequate supply of donor organs and changing demographics, patients listed for LT have become older, sicker and share more comorbidities. As cardiovascular events are the leading cause for early mortality precise evaluation of risk factors is mandatory. This review focuses on the detection and management of coronary artery disease, cirrhotic cardiomyopathy, portopulmonary hypertension and hepatopulmonary syndrome in patients awaiting LT. Further insights are being given into scoring systems, patients with Acute-on-chronic-liver-failure (ACLF), frailty, NASH cirrhosis and into psychologic evaluation of patients with substance abuse.

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来源期刊
CiteScore
0.80
自引率
25.00%
发文量
115
审稿时长
6-12 weeks
期刊介绍: AINS ist die Fachzeitschrift für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie im Georg Thieme Verlag. Sie vermittelt aktuelles Fachwissen und bietet Fortbildung. AINS hat sich das Ziel gesteckt, den Leserinnen und Lesern – Fachärzten und Weiterbildungsassistenten in der Anästhesiologie – immer praxisbezogenen Nutzwert und größtmögliche Unterstützung zu bieten.
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