骨科加速康复围手术期康复治疗的认识与探讨

Understanding and discussion of perioperative rehabilitation treatment for enhanced recovery after orthopedic surgeries

加速康复外科(ERAS)理念已在骨科深入推广,大量研究证实,系统规范的康复治疗能够有效促进患者关节活动度、肌肉力量、机体平衡稳定及控制能力的恢复,减少关节僵硬、肌肉萎缩、肢体无力等骨科常见的术后功能不良的发生,有利于患者早日回归社会和工作,节约医疗资源,降低医疗费用。骨科加速康复围手术期康复治疗包括术前康复治疗和术后康复治疗两部分。术前康复治疗包括术前门诊康复评估与治疗和术前住院康复评估与治疗;术后康复治疗包括术后早期康复评估与治疗、出院前康复评估与治疗和出院后康复评估与治疗,以及康复治疗场地的分级管理。本文将对骨科加速康复围手术期康复评估与治疗中手术医师与康复医师、康复治疗师的合作进行探讨,供骨科医师和康复医师参考应用,共同合作造福患者。

The concept of enhanced recovery after surgery(ERAS)has been widely promoted in orthopedics.A large number of studies have confirmed that systematic and standardized rehabilitation therapy can effectively promote the recovery of patients'joint motion,muscle strength,body balance stability and control ability,reduce joint stiffness,muscle atrophy,limb weakness and other common orthopedic postoperative dysfunction,which are conducive to the early return of patients to society and work,save medical resources,and reduce medical costs.The perioperative rehabilitation includes two parts:preoperative rehabilitation and postoperative rehabilitation.Preoperative rehabilitation includes preoperative outpatient rehabilitation assessment and treatment and preoperative hospitalization rehabilitation assessment and treatment.Postoperative rehabilitation includes early postoperative rehabilitation assessment and treatment,rehabilitation assessment and treatment before discharge,rehabilitation assessment and treatment after discharge,as well as the graded management of rehabilitation treatment site.In this article the cooperation between surgery physicians,rehabilitation physicians and rehabilitation therapists in the perioperative rehabilitation evaluation and treatment of orthopedics were discussed,so as to provide better cooperation between orthopedics physicians and rehabilitation physicians for the benefit of patients.