协和医学杂志

2019, v.10(06) 582-588

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循证观念改善临床结局:妇科/肿瘤加速康复指南2019年更新及解读
The Concept of Evidence-based Medicine Leads to Better Clinical Outcomes:Guidelines for Enhanced Recovery after Surgery in Gynecologic/Oncology 2019 Update and Interpretation

王巍;潘凌亚;
WANG Wei;PAN Ling-ya;Department of Gynecological Oncology,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)目前已在全球范围内明确成为一项能够改善医疗服务、降低医疗成本的手术质量改善倡议。妇科/肿瘤ERAS指南发表于2016年2月,ERAS协会以及国际ERAS妇科分会于2019年2月依据现有最高质量的文献证据进行了首次更新。其中新增预康复、预防手术部位感染策略、患者报告结局、盆腔廓清及腹腔热灌注化疗、出院路径、ERAS评估及报告等6条,更新文献证据级别及推荐级别10条,其他5条未发生变化。本次指南更新从围手术期管理方面为妇科/肿瘤临床实践明确了发展方向。
Enhanced Recovery After Surgery( ERAS) is now firmly established as a global initiative for the improvement of surgical quality,which results in both clinical improvements and cost benefits to the healthcare system. The ERAS Gynecologic/Oncology guidelines were first published in February 2016. It had been updated in February 2019,representing the joint efforts of the ERAS Society( www. erassociety. org) and the authors from the international ERAS Gynecology chapters,to present an updated consensus review of perioperative care for gynecologic/oncology surgery based on the best current evidence. There are six new items for 2019 guidelines,including prehabilitation,surgical site infection reduction bundles,patient-reported outcomes,pelvic exenteration and hyperthermic intraperitoneal chemotherapy,discharge pathways,and audit and reporting.Compared with the 2016 guidelines,the currently updated guidelines have ten items with differences in the quality of evidence and recommendation grade and five items with no change. This updated ERAS guidelines aim to further disclose the direction of the perioperative clinical practice of gynecologic/oncology.

关键词(KeyWords): 加速康复外科;妇科肿瘤;更新;指南解读
enhanced recovery after surgery;gynecologic oncology;update;guideline interpretation

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作者(Author): 王巍;潘凌亚;
WANG Wei;PAN Ling-ya;Department of Gynecological Oncology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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