协和医学杂志

2018, v.9(06) 496-500

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加速胃肠功能康复的麻醉和围手术期策略
Strategies of Anesthesia and Perioperative Recovery to Enhance the Gastrointestinal Function

朱阿芳;黄宇光;
ZHU A-fang;HUANG Yu-guang;Department of Anesthesiology,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)通过整合一系列围手术期优化策略,以期降低患者应激反应、减少术后并发症及缩短住院时间,最终达到加速患者康复的目标。就目前国内外研究现状而言,ERAS应用最多最成功的领域依然是胃肠外科,而诸如术前未纠正的营养风险状态、术前长时间禁食水、围手术期容量过负荷及过量使用阿片类药物等各项管理不当的麻醉和围手术期策略均可能对胃肠功能造成一定程度损害,进而增加术后并发症、延长住院时间并阻碍康复进程。因此规范ERAS中与胃肠功能相关的各项麻醉和围手术期策略,对改善患者结局具有十分重要的意义。
The concept of enhanced recovery after surgery( ERAS) is to optimize a series of perioperative measures to relieve surgical stress,reduce postoperative complications,shorten hospital stays,and finally accelerate the recovery. Gastroenterology is still the most studied and most successful field in the present research status of ERAS. However,many improperly implemented strategies of ERAS,like unresolved preoperative malnutrition,long fasting,perioperative hypervolemia,and overuse of opioid analgesics,could all damage the gastrointestinal function,and the impaired gastrointestinal function could impede the progress of ERAS by increasing postoperative complications and delaying hospital stays. Thus,it is critical to standardize the strategies of anesthesia and perioperative ERAS related to the gastrointestinal function in order to improve patient outcomes.

关键词(KeyWords): 加速康复;目标导向液体治疗;营养风险筛查;术后胃肠功能障碍
enhanced recovery;goal-directed fluid therapy;nutrition screen;postoperative gastrointestinal dysfunction

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81671098)

作者(Author): 朱阿芳;黄宇光;
ZHU A-fang;HUANG Yu-guang;Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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