Importanta Factorilor de Risc la Pacientul Chirurgical

Cuprins

I. INTRODUCERE

Motivatie – importanta

Notiunea de risc

Perioada preoperatorie – componente, obiective

II. RISCUL CHIRURGICAL

Traumatismul operator – fiziopatologie, implicatii

Sistematizare interventii chirurgicale

Riscul septic si antibioprofilaxia

Factori de risc in chirurgia abdominala

Abdomenul acut chirurgical

Laparotomia

Colecistita acuta si chirurgia biliara

Ocluzia intestinala

Cancerul colorectal

III. RISCUL ANESTEZIC

Cauzele complicatiilor anestezice

Scheme de evaluare stratificare si reducere a riscului

Raport cost / beneficiu in identificarea factorilor risc

Riscul si factorul uman

IV. RISCUL SI TERENUL

Factori generali

Starea generala

Varsta si sexul

Riscul cardiac

Riscul pulmonar

Riscul hepatic

V. SCALE DE RISC

IMPORTANTA FACTORILOR DE RISC LA

PACIENTUL CHIRURGICAL

Bibliografie

Pagini 87

Bibliografie

1.Buck N., Devlin H.B., Lunn J.N. : “Report of a confidential enquiry into peri-operative deaths”, London; Nuffield Provincial Hospital Trust, 1987;

2.Centralizatorul activitatii Spitalului Clinic de Urgenta Bucuresti 1997, 1998;

3.Ray R. C., Overdyk F. in “Patient safety in anesthetic practice” sub red. R. C. Norell, J. Eichkorn, ed. C. Livingstone 1997, p. 163-173;

4. Voelker R.: “Anesthesia – related risks have plummeted”, JAMA 272:445, 1995;

5. Litarczek G.: “Vizita preoperatorie si preanestezica. Evaluarea bolnavului” in “Tratat de patologie chirurgicala” sub redactia E. Proca;

6. Ciobanu I., Cristea C. : ”Noul ghid de anestezie – terapie intensiva” ,Ed.Med. 1995;

7.Campbell D., Spence A.: “Norris and Campbell’s Anaesthetics, Resuscitation and Intensive care”, ed. Ch. Livingstone 1990, p. 53;

8.Pasternak L.R.: “Preoperative evaluation – a systematic approach”, Annual Course Lecture 421, ASA, Atlanta 1995;

9.Wesley A. J.: “Manual of preoperative and postoperative care”, American College of Surgeons, third edition;

10.Moisescu E.et al : “Antibioprofilaxia in chirurgia abdominala, ortopedica, vasculara, plastica si neurochirurgie”;

11.Diculescu M. : “Hemoragiile digestive superioare” in “Medicina Interna”, vol. 3, sub redactia L. Gherasim , Ed. Medicala, Bucuresti 1999;

12.Acalovsky M. si Acalovsky I.: “Terenul digestiv, hepatic si hepatobiliar” in ”Tratat de patologie chirurgicala”, sub redactia Eugen Proca, Ed. Medicala, Bucuresti 1998;

13.Ranson J.H., Rifkind K.M., Spencer F.C.: “Prognostic signes and role of operative management in acute pancreatitis”, Surg. Gynec. Obstret. 1974,139, 69 – 81;

14.Lagasse R.S., Steinberg E.S., Katz R.I., Sauberman A.J.: “Defining quality of perioperative care by statistical process control of adverse outcames”, Anesthesiology 82:1181, 1995;

15.American Society of Anesthesiologists: “New classification of physical status”, Anesthesilogy 24:111, 1963;

16.Wark K.J.: “Paediatric anaesthesia” in “Anaesthesia,Analgesia and Intensive Care” sub red. Anthony P. Adams and Jeremy Cashman;

17.Litarczeck G., Florescu R., Dobre A.: “Bolnavul chirurgical fara tare” in “Tratat de patologie chirurgicala”, vol. 2, Ed. Medicala, Bucuresti 1998;

18.Segal E.: “The preoperative Evaluation of the Patient Whith Heart Disease”,” Problems in Anesthesia”, vol. 6, No. 1, Martie 1992 ;

19.Goldman L., Caldera D.L.: “Multifactorial index of cardiac risk in non – cardiac surgical procedures”, N. Engl. J. Med. 297:845, 1997;

20.Goldberger A.L., O’Konski M.: “Utility of the routine electrocardiogram before surgery”, Ann. Intern. Med. 105:552 – 557;

21.McGaugh E.: “The patient with pulmonary disease”, “Problems in Anesthesia”, vol. 6, NO. 1, Martie 1992;

22.Gaensler E.A., Cugell D.W., Lindgren: “The role of pulmonary insufficiency in mortality and invalidism fallowing surgery”, J. Thorac Surg.55, 1968;

23.Mittman C.: “Assesment of operative risk in thoracic surgery”, Am. Rev. Respir. Dis. 84, 1961;

24.Nehaus H., Cherniack H.S.: “A bronchospirometric method of estimating the effect of pneumonectomy “, J. Thorac. Cardiovasc. Surg. ,1968;

25.Wernly J. A., De Meester T.R., Kirchner P.T.: “Clinical value of quantitative ventilation – perfusion lung scans”, Scand J. Thorac. Cardiovasc. Surg.80, 1980;

26.Baysen P.G.: “Preoperative pulmonary function totaling” in “Shemaker Critical Care – State of the Art”, vol. 6, Philadelphia, WB Saunder Co., 1985;

27.Shapiro B.A.: “Evaluation of respiratory function in the perioperative period.” in “Annual Refresher Course Lectures”, ASA 1979;