加速康复外科在结直肠外科应用中应关注的若干问题

Some problems in application of enhanced recovery after surgery in colorectal surgery

加速康复外科(ERAS)在结直肠外科应用已有多年,微创手术的发展及围手术期一系列干预措施的革新,提高了患者的康复速度,减少了术后住院时间和治疗费用。目前国内结直肠外科领域ERAS推广和普及程度还不能令人满意,医护人员的理念、患者的认识不足、诊疗模式的限制及卫生政策的缺乏等因素是阻碍其临床实践的重要原因。通过建立ERAS临床路径、发展MDT诊疗模式、优化诊疗流程、成立ERAS示范中心、加强患者宣教及制定相关政策有助于推动ERAS在结直肠外科的开展,使广大患者和医护人员受益。

Enhanced recovery after surgery（ERAS） has been used in colorectal surgery for many years. The development of minimally invasive surgery and a series of intervention measures innovation in perioperative period improved the recovery rate of patients, reduced the postoperative hospitalization time and treatment costs. At present, the domestic application and popularization degree of ERAS in colorectal surgery was still unsatisfactory. Some factors may hinder its clinical practice, such as the concept of medical staffs, the weak awareness of patients, the restriction of medical treatment mode and the lack of health policy. Establishing clinical pathway of ERAS, developing MDT mode, optimizing treatment processes, forming demonstration center, strengthening the education of patients and formulating relevant policies can promote ERAS application in colorectal surgery, which will benefit the majority of patients and medical staffs.