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JAMA Surg:快速了解热点—加速术后康复(ERAS)

2017-01-19 MedSci MedSci原创

加速术后康复(ERAS)是围手术期护理模式的转变,是临床结果和成本节约的实质性改善。加速术后康复是一种多模式、多学科的手术患者护理方法。加速术后康复的实施过程涉及由外科医生、麻醉师、ERAS协调员(通常是护士或医生助理)组成的团队,以及护理手术患者的工作人员完成。护理流程基于已经发表的证据。ERAS协会是一个促进开发和实施ERAS计划的国际非营利专业协会,发布了许多操作的更新指南。例如,从手术前2

加速术后康复(ERAS)是围手术期护理模式的转变,是临床结果和成本节约的实质性改善。

加速术后康复是一种多模式、多学科的手术患者护理方法。加速术后康复的实施过程涉及由外科医生、麻醉师、ERAS协调员(通常是护士或医生助理)组成的团队,以及护理手术患者的工作人员完成。护理流程基于已经发表的证据。ERAS协会是一个促进开发和实施ERAS计划的国际非营利专业协会,发布了许多操作的更新指南。例如,从手术前2小时,从隔夜禁食到碳水化合物饮料的基于证据的现代护理变化,采用微创方法,而不是大切口,液体的管理以寻求平衡而不是大量的静脉内输液,避免或早期拔出引流管,早期动员,以及在手术当天提供饮料和食物。

加速术后康复方案使患者住院时间缩短30%至50%,类似的并发症减少,而再住院和医疗费用减少。流程可以减少手术的压力以保持合成代谢的动态平衡。

ERAS协会目前在20多个国家使用结构化实施计划。来自医院本地的ERAS团队接受培训,以实施ERAS流程。对过程合规性和患者结果的审计是重要特征。ERAS主要开始于结直肠手术,但已显示几乎可以改善所有主要的外科专科结果。

结语:ERAS是一种基于证据的手术患者护理改善的过程。ERAS程序的实施导致临床结果和医疗成本的重大改进。

原始出处:
Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017 Jan 11. doi: 10.1001/jamasurg.2016.4952.

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    2017-02-15 瑞德

    有具体流程图吗?

    0

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    2017-01-20 忠诚向上

    好好学习

    0

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    2017-01-20 1e10c84am36(暂无匿称)

    文章太好了,多读受益

    0

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    2017-01-20 天涯183

    非常好的进展

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1676980, encodeId=4daf16e69807b, content=<a href='/topic/show?id=9fd161052bc' target=_blank style='color:#2F92EE;'>#术后康复#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61052, encryptionId=9fd161052bc, topicName=术后康复)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=480b27414313, createdName=wwzzly, createdTime=Thu Aug 03 23:33:00 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176328, encodeId=01501e632832, content=有具体流程图吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63822007469, createdName=瑞德, createdTime=Wed Feb 15 21:19:31 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1738807, encodeId=96411e388077f, content=<a href='/topic/show?id=6e566913df' target=_blank style='color:#2F92EE;'>#ERA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6913, encryptionId=6e566913df, topicName=ERA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e36234488643, createdName=124988c7m106暂无昵称, createdTime=Fri Jul 21 21:33:00 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171576, encodeId=7b971e1576c4, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jan 20 11:34:02 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171551, encodeId=b90c1e155171, content=文章太好了,多读受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, 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 Jan 20 10:17:58 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171514, encodeId=cc571e15144c, content=非常好的进展, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Jan 20 07:59:48 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171505, encodeId=12831e1505ef, content=很好的内容,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Fri Jan 20 07:46:40 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171475, encodeId=bff31e1475c0, content=好好学习天天,向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Jan 20 05:53:35 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171459, encodeId=f9a51e145910, content=谢谢了,写下来, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Jan 20 00:03:56 CST 2017, time=2017-01-20, status=1, ipAttribution=)]
    2017-01-20 1dd8aa01m06(暂无匿称)

    很好的内容,学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1676980, encodeId=4daf16e69807b, content=<a href='/topic/show?id=9fd161052bc' target=_blank style='color:#2F92EE;'>#术后康复#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61052, encryptionId=9fd161052bc, topicName=术后康复)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=480b27414313, createdName=wwzzly, createdTime=Thu Aug 03 23:33:00 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176328, encodeId=01501e632832, content=有具体流程图吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63822007469, createdName=瑞德, createdTime=Wed Feb 15 21:19:31 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1738807, encodeId=96411e388077f, content=<a href='/topic/show?id=6e566913df' target=_blank style='color:#2F92EE;'>#ERA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6913, encryptionId=6e566913df, topicName=ERA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e36234488643, createdName=124988c7m106暂无昵称, createdTime=Fri Jul 21 21:33:00 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171576, encodeId=7b971e1576c4, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jan 20 11:34:02 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171551, encodeId=b90c1e155171, content=文章太好了,多读受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, 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 Jan 20 10:17:58 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171514, encodeId=cc571e15144c, content=非常好的进展, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Jan 20 07:59:48 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171505, encodeId=12831e1505ef, content=很好的内容,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Fri Jan 20 07:46:40 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171475, encodeId=bff31e1475c0, content=好好学习天天,向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Jan 20 05:53:35 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171459, encodeId=f9a51e145910, content=谢谢了,写下来, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Jan 20 00:03:56 CST 2017, time=2017-01-20, status=1, ipAttribution=)]
    2017-01-20 zwjnj2

    好好学习天天,向上

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1676980, encodeId=4daf16e69807b, content=<a href='/topic/show?id=9fd161052bc' target=_blank style='color:#2F92EE;'>#术后康复#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61052, encryptionId=9fd161052bc, topicName=术后康复)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=480b27414313, createdName=wwzzly, createdTime=Thu Aug 03 23:33:00 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176328, encodeId=01501e632832, content=有具体流程图吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63822007469, createdName=瑞德, createdTime=Wed Feb 15 21:19:31 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1738807, encodeId=96411e388077f, content=<a href='/topic/show?id=6e566913df' target=_blank style='color:#2F92EE;'>#ERA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6913, encryptionId=6e566913df, topicName=ERA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e36234488643, createdName=124988c7m106暂无昵称, createdTime=Fri Jul 21 21:33:00 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171576, encodeId=7b971e1576c4, content=好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jan 20 11:34:02 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171551, encodeId=b90c1e155171, content=文章太好了,多读受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, 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 Jan 20 10:17:58 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171514, encodeId=cc571e15144c, content=非常好的进展, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Fri Jan 20 07:59:48 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171505, encodeId=12831e1505ef, content=很好的内容,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Fri Jan 20 07:46:40 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171475, encodeId=bff31e1475c0, content=好好学习天天,向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Fri Jan 20 05:53:35 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=171459, encodeId=f9a51e145910, content=谢谢了,写下来, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Jan 20 00:03:56 CST 2017, time=2017-01-20, status=1, ipAttribution=)]
    2017-01-20 txqjm

    谢谢了,写下来

    0

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