Array ( [id] => 677 [catid] => 71 [title] => Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/677.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => French Society of Anaesthesia and Intensive Care M [pdf] => [tjyjyw] => [lyyw] => It is probably recommended to assess and treat preoperatively any nutritional deficiency before cardiac surgery to reduce the occurrence of postoperative complications.(GRADE 2+ STRONG AGREEMENT) [laiyuan] => 推荐心脏手术前对营养缺乏进行评估和治疗，以减少术后并发症的发生。(GRADE 2+ STRONG AGREEMENT) [znzldj] => B [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 678 [catid] => 70 [title] => Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/678.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => French Society of Anaesthesia and Intensive Care M [pdf] => [tjyjyw] => [lyyw] => It is probably recommended to promote a cardiorespiratory and muscular prehabilitation programme before cardiac surgery to reduce the occurrence of postoperative complications and the length of stay in hospital.(GRADE 2+ STRONG AGREEMENT) [laiyuan] => 推荐在心脏手术前实施心肺和肌力康复预案，以减少术后并发症的发生和住院时间。(GRADE 2+ STRONG AGREEMENT) [znzldj] => B [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 679 [catid] => 70 [title] => Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/679.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => French Society of Anaesthesia and Intensive Care M [pdf] => [tjyjyw] => [lyyw] => It is recommended that smoking cessation be obtained as soon as possible before cardiac surgery to reduce postoperative complications, particularly respiratory complications. [laiyuan] => 推荐心脏手术前尽早戒烟，以减少术后并发症的发生，尤其是呼吸系统并发症。(GRADE 1+ STRONG AGREEMENT) [znzldj] => B [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 680 [catid] => 70 [title] => Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump [thumb] => [keywords] => [description] => [hits] => [uid] => 1 [author] => 系统管理员 [status] => 9 [url] => /show/680.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => [demo_url] => [zjpjff] => GRADE [zjfj] => [tjqd] => [nianfen] => 2022 [guojia] => French Society of Anaesthesia and Intensive Care M [pdf] => [tjyjyw] => [lyyw] => It is probably recommended to provide appropriate information and education using several supports to patients before cardiac surgery to reduce the incidence of postoperative complications.(GRADE 2+ STRONG AGREEMENT) [laiyuan] => 推荐在心脏手术前通过多种辅助手段向患者进行适当的术前宣教，以减少术后并发症的发生。(GRADE 2+ STRONG AGREEMENT) [znzldj] => B [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 681 [catid] => 25 [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] => /show/681.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [displayorder] => 0 [nrjc] => Array ( ) [nrsh] => Array ( ) [xzl] => 0 [dzl] => 0 [wailian] => https://oss.wanfangdata.com.cn/Catalog/List?fileId=perio_xhyx202105007&transaction=%7B%22id%22%3Anull%2C%22transferOutAccountsStatus%22%3Anull%2C%22transaction%22%3A%7B%22id%22%3A%221742894109258960896%22%2C%22status%22%3A1%2C%22createDateTime%22%3Anull%2C%22payDateTime%22%3A1704373311711%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_xhyx202105007%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%22Z4YG4x9U6sG%2FxmTQbQRsnVB62GFz%2FI1r0p3sy%2ByyOq7RLGSubW876CvIZj%2BaIqpHDyZbKlxKZdif%5CngmYiEV%2BeCkfV8al1Yu2vGNRmCurWq%2FsHxQZiA0QLH6igx3Yt7pLbRCpQtnH4VfjDCU5gQVadlcIY%5Cn%2FRBxlWi0uti7bRf6YjI%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] => 宣教活动应贯穿于病人从入院前到出院后的全过程，提高病人对肝胆外科疾病、手术过程的认知水平及其依从性。（证据等级：低；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 682 [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] => /show/682.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [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] => 复杂肝胆外科手术前须行包括营养、心理及虚弱状态等的多学科评估，个体化制订并实施包括运动、营养、心理干预等预康复计划。（证据等级：高；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 683 [catid] => 31 [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] => /show/683.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [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] => 根据病人病情和切除范围选择最佳入肝血流阻断方式；在保证器官灌注基本正常的前提下实施CLCVP（CVP＜5cmH2O）技术；肝下下腔静脉阻断技术可有效降低来自肝静脉的出血；应基于肝脏的特点及术者的熟练程度选择适宜的肝实质离断方式。（证据等级：中；推荐强度：一般性推荐） [znzldj] => C [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 684 [catid] => 29 [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] => /show/684.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [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] => 对于创伤大的肝胆外科手术，实施全静脉或静吸复合全身麻醉联合硬膜外阻滞或区域神经阻滞；术后镇痛以连续神经阻滞（竖脊肌阻滞、胸椎旁阻滞和腹横肌平面阻滞）或局麻药切口浸润镇痛为基础，联合静脉使用NSAIDs药物和（或）低剂量阿片类药物+止吐药的多模式镇痛方案，覆盖术后48～72h以上。实施预防性镇痛有助于术中应激控制和术中术后全程疼痛管理。（证据等级：高；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 685 [catid] => 31 [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] => /show/685.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [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] => 在肝脏外科手术中实施控CLCVP（CVP＜5cmH2O）技术以减少术中出血。在循环、容量和全身器官灌注的监测下应用动态液体管理、完善的麻醉及联合使用去甲肾上腺素等综合措施，避免CLCVP相关并发症。（证据等级：中；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )

Array ( [id] => 686 [catid] => 39 [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] => /show/686.html [link_id] => 0 [tableid] => 0 [inputip] => 14.105.95.222 [inputtime] => 2024-01-11 15:13:24 [updatetime] => 2024-01-11 15:13:24 [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] => 围手术期血糖水平应控制在6.0~10.0mmol/L范围内，对血糖控制不佳的病人（如糖尿病病人）可行胰岛素治疗。通过围手术期抗应激措施防治应激性高糖血症及过度炎性反应。（证据等级：中；推荐强度：强推荐） [znzldj] => C [_inputtime] => 1704957204 [_updatetime] => 1704957204 [_nrjc] => [_nrsh] => )