协和医学杂志

2018, v.9(06) 501-507

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妇科加速康复外科管理路径
Perioperative Management of the Program of Enhanced Recovery after Surgery in Gynecology

刘海元;任远;孙大为;
LIU Hai-yuan;REN Yuan;SUN Da-wei;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

加速康复外科(enhanced recovery after surgery,ERAS)是以循证医学为基础,以减少手术创伤与应激为目的,通过优化围手术期临床路径,促进患者术后快速恢复。其基本原则包括:术前宣教、取消常规肠道准备、术前2 h摄入含糖饮料、多模式镇痛、术中体温监测、优化液体管理、避免放置引流、术后早期进食及下床活动等。ERAS的成功实施需要多学科密切合作,制定可供临床遵循的规范与流程,但同时需充分结合各医疗中心实际条件与患者具体情况,在标准化的同时做到个体化、最优化,使患者实际获益。
Enhanced recovery after surgery( ERAS) refers to a series of perioperatively optimized interventions based on evidence-based medicine,to reduce surgical stress and accelerate postoperative recovery of patients. The basic principles of ERAS include preoperative counseling,elimination of routine bowel preparation,preoperative carbohydrate uploading,multimodal analgesia,intraoperative temperature monitoring,optimized fluid infusion,avoidance of drainage placement,early postoperative feeding and ambulation. Studies have shown that ERAS can significantly shorten the length of hospital stay,reduce perioperative complications,save hospitalization expenditure,improve the patient's life quality,and may benefit patients in the long term. The successful implementation of ERAS requires combined efforts of multiple disciplines to develop a standard protocol for clinical practitioners,while the actual situation of each medical center and the specific condition of each patient should be fully investigated to achieve individualization and optimization at the same time.

关键词(KeyWords): 加速康复外科;妇科手术;围手术期管理;多模式镇痛;临床路径
enhanced recovery after surgery;gynecologic surgery;perioperative management;multimodal analgesia;clinical pathway

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作者(Author): 刘海元;任远;孙大为;
LIU Hai-yuan;REN Yuan;SUN Da-wei;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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