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影响围术期食管胃手术吻合口瘘发生的危险因素:营养不良、吸烟、应用类固醇类药物、肠道准备、化学治疗、手术时间、使用升压药物、静脉输液管理、输血以及手术吻合技术等,提高外科医生识别吻合口瘘高风险患者的能力可尽量减少并发症发生。本文总结了针对这些危险因素具体措施:对营养不良者术前给予5~7 d改善免疫的营养治疗、充分的肠道准备、围术期戒烟、限制应用类固醇和升压药物、避免化疗后4周内手术及运用目标导向的液体管理。
Risk Factors Affecting Anastomotic Fistula During Perioperative Esophageal Stomach Surgery: Malnutrition, smoking, steroid use, gut preparation, chemotherapy, duration of surgery, use of antihypertensive drugs, intravenous fluid management, blood transfusion and surgical stapling techniques , Increasing the surgeon’s ability to identify patients at high risk of anastomotic leakage can minimize complications. This article summarizes the specific measures for these risk factors: malnutrition preoperative treatment given 5-7 days to improve immune nutrition, adequate bowel preparation, perioperative smoking cessation, limiting the use of steroids and antihypertensive drugs to avoid chemotherapy 4 Weekly surgery and use of targeted liquid management.