快速康复外科理念下骨折患者营养管理的研究进展

Nutritional management in enhanced recovery after fracture surgery

骨折通常由于暴力创伤导致,其治疗难点在于骨折本身及其复杂的合并症,若不能恰当处理,易引发一系列问题,影响骨折愈合。为解决该难题,人们提出快速康复外科(enhanced recovery after surgery,ERAS)的概念。ERAS是一种基于循证医学证据的围术期多模式、多系统协同干预措施,可维持身体内环境稳定和器官功能,减轻患者围术期生理、心理应激反应,旨在实现术后快速康复。其核心在于"无应激、无痛、无风险"。目前ERAS技术在骨科应用的相关研究经验正在逐步积累。本文将对ERAS技术在骨科中的研究现状,以及ERAS营养管理中营养评估、禁食与进食管理、微生物制剂的使用等内容进行综述,为临床治疗和研究提供参考。

Fracture is usually caused by violent injury. The difficulty of its treatment lies in fracture itself and its comorbidities. If not properly handled, the fracture and comorbidities will lead to a series of physiological and psychological problems, which will further affect fracture healing. To solve this problem, the concept of Enhanced Recovery After Surgery （ERAS） is proposed. ERAS, based on evidence based medicine, is a perioperative multi-mode collaborative intervention concept, aiming at rapid recovery after operation by maintaining homeostasis and reducing stress response of the body. The core of this concept lies in ＂stress-, pain- and risk-free＂. At present, evidence of ERAS application in orthopedics is accumulating. In this paper, we will review the research status of ERAS in orthopedics and relevant issues on nutritional management.