快速康复外科理念在头颈部肿瘤手术围手术期中的应用

The application of the concept of enhanced recovery after surgery in perioperative period of head and neck tumors

近年来基于新的麻醉和止痛技术的发明、微创手术的发展以及减少手术应激反应药物的发现,快速康复外科(enhanced recovery after surgery,ERAS)理念得以提出与推广,并成为国际医疗领域新潮流。ERAS理念贯穿整个围手术期,并通过一系列的优化措施,以患者为核心,以循证医学及多学科合作为基础,其核心理念是促进患者术后康复,减少手术应激对患者心理及生理上的不利影响,减少术后并发症,缩短住院时间,减少住院费用并改善就医体验,进而合理使用分配有限的医疗资源。鉴于头颈部肿瘤解剖位置的特殊性,且手术创伤大,手术方式复杂,往往导致患者术后康复缓慢,并发症发生率居高不下,故将ERAS理念引入头颈外科有助于推动现有诊疗模式的优化。

In recent years,the concept of enhanced recovery after surgery(ERAS)has been put forward and popularized based on the invention of new anesthesia and analgesic techniques,the development of minimally invasive surgery,and the discovery of drugs to reduce surgical stress response,which has become a new trend in the international medical field.The concept of ERAS penetrates the entire perioperative period by a series of optimization measures.ERAS regards patients as the core on the basis of the evidence-based medicine and multidisciplinary cooperation.Its core idea philosophy is to promote patients postoperative rehabilitation for reducing the side effects of surgical stress on the psychological and physiological of patients and decreasing the postoperative complications to shorten the postoperative hospitalization.ERAS reduces hospitalization costs,and improves medical experience,lessens hospital costs,accumulates medical experience and allocates the limited medical resources rationally.The anatomical position of head and neck tumor is special,and the surgical trauma is large,and the surgical method is complex.Therefore,patients often recover slowly after surgery.The incidence of the surgical complications is high,so the concept of ERAS is helpful to promote the optimization of the optimization of the current diagnosis and treatment mode.