加速康复外科临床应用现状与思考

Enhanced Recovery after Surgery Protocol Applying in Perioperative Treatment:Current Status and Issues

加速康复外科(enhanced recovery after surgery,ERAS)理念已被大家广泛接受,微创理念和技术运用和多学科合作已在众多外科手术中应用,且取得了比较好的临床效果,但临床应用中也有争议,这些争议阻碍了ERAS的推广。本文从以下几方面综述ERAS应用中的共识和争议:1 ERAS理念演进及其内涵和外延的变化;2 ERAS临床应用效果评价标准的共识与争议?3医生和患者应用ERAS依从性差的原因?4多模式和多学科协作在ERAS临床应用中的作用;5 ERAS临床应用中的困难与对策。

The concept of enhanced recovery after surgery（ERAS） has been well accepted by medical providers, which can be realized by a multidisciplinary team approach and minimally invasive surgical technology performed during perioperative periods. As the outcomes of the ERAS protocols, well effects are anticipated, and consistent outcomes are actually obtained. At the same time, there are some aspects which are not consistent including （1） the evolution and challenge of ERAS concept： connotation and extension, （2） consensus and arguments on the evaluation standard of ERAS protocol, （3） the cause of poorly compliance in medical providers and patient, （4） the function of multimodal programme and multidisciplinary team approach in ERAS protocol, which one is better？ （5） methods and barriers of implementing enhanced recovery in clinic application.