《中国加速康复外科围手术期管理专家共识(2016)》发布(附指南下载)

2016-07-14 中华外科杂志 中华外科杂志

近年来,加速康复外科(ERAS)理念在全球的应用已逐步拓展至骨科、心胸外科、妇产科、泌尿外科、普通外科等领域,均取得了良好效果。但目前ERAS理念在国内尚处于不断完善与发展的过程中,正在逐步形成中国特色的ERAS路径。在此背景下,普通外科、麻醉科、胸心外科、神经外科等领域的专家结合文献及ERAS在国内开展的实际情况,共同制定了《中国加速康复外科围手术期管理专家共识(2016)》(简称共识),以进一

近年来,加速康复外科(ERAS)理念在全球的应用已逐步拓展至骨科、心胸外科、妇产科、泌尿外科、普通外科等领域,均取得了良好效果。但目前ERAS理念在国内尚处于不断完善与发展的过程中,正在逐步形成中国特色的ERAS路径。在此背景下,普通外科、麻醉科、胸心外科、神经外科等领域的专家结合文献及ERAS在国内开展的实际情况,共同制定了《中国加速康复外科围手术期管理专家共识(2016)》(简称共识),以进一步规范并促进多学科综合诊疗模式下ERAS理念在国内临床实践中的应用。

ERAS指为使患者快速康复,在围手术期采用一系列经循证医学证据证实有效的优化处理措施,减轻患者心理和生理的创伤应激反应。

术前准备  完善的术前准备可使患者具有充分的心理准备和良好的生理条件,包括术前宣教、营养筛查、预防性应用抗菌药物及抗血栓治疗、个体化的血压和血糖控制及相应的管理方案等。

呼吸系统管理  呼吸系统管理是ERAS的重要环节,且贯穿围手术期全程。对高危患者积极进行干预有助于提高肺功能及对手术的耐受性,可明显降低术后肺部并发症发生率,缩短住院时间。疼痛治疗疼痛治疗是ERAS非常重要的环节,提倡建立由麻醉医师、外科医师、护理与药剂人员组成的术后急性疼痛管理团队,以提高术后疼痛治疗质量,提高患者的舒适度和满意度,减少术后并发症。

减少手术应激  减少手术应激是ERAS理念的核心原则,也是患者术后康复得以加速的基础。减少手术应激的基本原则为精准、微创及损伤控制。

营养支持  合理的营养支持应充分了解机体各种状况下的代谢变化,正确进行营养状况评估,选择合理的营养支持途径,提供合适的营养底物,尽可能地避免或减少并发症的发生。

指南下载

中国加速康复外科围手术期管理专家共识(2016)(需要扣积分2分, 梅斯医学APP免积分下载)


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    2016-10-09 1e10c84am36(暂无匿称)

    文章很好,继续关注

    0

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    2016-09-16 1e10c84am36(暂无匿称)

    不错哦,会学到很多

    0

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    2016-09-05 李东泽

    很好,不错,以后会多学习

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=2053743, encodeId=161f2053e4348, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun Nov 13 17:36:00 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142693, encodeId=1593142693d6, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Oct 09 15:57:15 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128475, encodeId=40dd1284e55b, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:27:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111621, encodeId=9ef211162127, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 16:50:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844497, encodeId=af1b184449e10, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri Aug 05 20:36:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93560, encodeId=1a249356054, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zGdN1x8J6HqtUI2Gpibk3sfIIBhZchAhjoiaCQlficdtQTnEqYncy3GVEMPIOJwD7t0mO2KfYGMgkIg/0, createdBy=86081727811, createdName=4546wk, createdTime=Tue Jul 19 11:40:00 CST 2016, time=2016-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1392845, encodeId=9c55139284539, content=<a href='/topic/show?id=84964065015' target=_blank style='color:#2F92EE;'>#围手术期管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40650, encryptionId=84964065015, topicName=围手术期管理)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b71f2500114, createdName=1179102698_36768926, createdTime=Sat Jul 16 01:36:00 CST 2016, time=2016-07-16, status=1, ipAttribution=)]
    2016-07-19 4546wk

    文章不错

    0

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