加速康复外科的特点及在二次剖宫产术中的应用

Characteristics of Enhance Recovery after Surgery and Its Application in Secondary Cesarean Section

随着现代医学的不断进步,加速康复外科(enhanced recovery after surgery,ERAS)于近年正风靡全球,成为引领临床医疗技术发展的新标杆。ERAS其内涵是遵循外科手术的基本原则基础,按照循证医学证据进行整合围手术期的优化处理措施,达到减轻患者心理和生理上的创伤应激反应,减少能量损耗,从而促进术后早期恢复的目的。剖宫产术是产科最常见的手术方式,是处理高危妊娠和异常分娩的重要手段。自近年国家实施"二孩"政策之后,瘢痕子宫再次怀孕的产妇日益增多。由于瘢痕子宫的手术难度加大,其手术安全性及不良妊娠结局一直引起临床高度关注。因此如何选择科学的围手术期方式成为产科医学工作者的研究热点。目前ERAS在外科手术领域中的安全性、可靠性和有效性已是有目共睹。将ERAS应用于瘢痕子宫的围手术期,通过对相关措施进行创新,确保受术者享受到目前最先进的医学与护理技术,从而能舒适且安全地度过围手术期。本文结合国内外相关文献就快速康复外科理念的特点及目前在二次剖宫产术中的应用现状进行简要综述。

With the continuous progress of modern medicine,the enhanced recovery after surgery(ERAS)has become a global trend in recent years,which has become a new benchmark for the development of clinical medical technology.ERAS is the connotation of following the basic principles of surgery and integrating the optimal treatment measures in the perioperative period according to evidence-based medical evidence,so as to reduce the psychological and physiological traumatic stress response of patients and reduce energy loss,thus promoting the early postoperative recovery.Cesarean section is the most common operation in obstetrics and is an important means to deal with high-risk pregnancy and abnormal delivery.Since the implementation of the"two-child"policy in recent years,the number of pregnant women with scarred uteruses has been increasing.Due to the difficulty of scar uterus operation,the safety and adverse pregnancy outcomes of scar uterus operation have been highly concerned in clinic.Therefore,how to choose a scientific perioperative mode has become a hot research topic for obstetrics medical workers.ERAS’safety,reliability and effectiveness in the field of surgery are now obvious.ERAS is applied to the perioperative period of scar uterus,and relevant measures are innovated to ensure that the recipient can enjoy the most advanced medical and nursing technology so as to comfortably and safely pass the perioperative period.In this paper,the characteristics of the concept of rapid rehabilitation surgery and its application in the second cesarean section were briefly reviewed based on the relevant literature at home and abroad.