加速康复外科临床实践中应重视的几个问题

Enhanced recovery after surgery: current controversies and concerns

加速康复外科(ERAS)基于循证医学基础,通过优化围手术期诊疗路径,达到促进术后康复的目的。ERAS的理论基础是减少围手术期应激及其导致的代谢改变。临床实践中应坚持以多学科合作为基础,针对病人的具体情况多模式、个体化地开展ERAS。提高手术质量、减少创伤应激是促进病人术后康复的重要途径。ERAS应与我国国情及临床的实际情况相结合,秉承安全第一、效率第二的基本原则。

The enhanced recovery after surgery（ERAS） protocol is an evidence based,perioperative care pathway,which is to reduce the physiological neuroendocrine stress response to surgery,with the ultimate goal of improving patient recovery and outcomes. In clinical practice, the multidisciplinary team,multimodal approach,and individualized program are necessary to get the ERAS protocol implemented. It is the most important approach for patient recovery to improve the quality of surgery so as to reduce the surgical stress. The goals of ERAS should be realistic and the related program should be implemented under national conditions by adhering to the principle of safety first,and efficiency second.