妇科术后快速康复中存在的问题及对策

Problems and Solutions in Enhanced Recovery after Surgery of Gynecological Operation

术后快速康复(enhanced recovery after surgery,ERAS)在妇科领域开展相对滞后,镇痛管理作为其中的重要内容,目前仍存在许多认知误区。综述了ERAS在妇科围术期开展中存在的问题,包括术前宣教不完善、多学科协作衔接不当、医患旧理念根深蒂固、镇痛管理不规范及人性化医疗匮乏等。对此提出如下解决对策:提高术前宣教内容质量、以人性化医疗为基础统一多学科ERAS开展的初衷与目的、通过本土化数据不断完善ERAS指南以及呼吁妇科围术期镇痛管理指南的出台,以此为妇科ERAS工作的完善提供帮助。

Enhanced recovery after surgery(ERAS)is relatively lagging behind in gynecology,of which analgesia management is an important part with many misunderstandings.This article reviews the problems of ERAS in gynecology,including incomplete pre-operative education,improper multidisciplinary collaboration,deep-rooted concept of doctor-patient relationship,nonstandard pain management and inadequate humanistic medical care,etc.Finally,the authors propose the corresponding solutions,including:improving the quality of pre-operative health education;targeting the original intentions and purposes of multidisciplinary development in ERAS based on providing humanistic medical care;localizing the guideline of ERAS and advocating gynecological perioperative analgesia management guidelines.By the above methods,it is hoped to strengthen the ERAS practice in gynecology.