摘要
加速康复外科（ERAS）整合了一系列优化的围术期处理措施，其目标是通过减轻围术期的各种应激反应，减少能量损耗，改善器官功能紊乱，加快患者术后康复。它最先应用于结直肠外科领域，随后逐渐向其他外科领域拓展。对于胃癌手术，其总体的有效性和安全性已得到循证医学的初步证实，但是对于ERAS的各个详细措施，目前还存在一定的争议。2014年欧洲加速康复外科协会制订并发布《胃切除术加速康复外科指南》，为医疗单位实施ERAS提供了优化的围术期处理方案。但在临床实践中，应该注意将指南与共识中的普遍原则与患者个体的特殊性有机地结合。由于胃癌手术的复杂性和患者情况的多样性，因此需要发展个体化的ERAS。未来ERAS的发展方向，一方面需要开展更多针对ERAS中各个措施的随机对照临床试验，以得出更加明确和有力的结论；另一方面，需要重视提高患者对各项措施的依从性。
Enhanced recovery after surgery （ERAS） combines various techniques used in the care of patients under- going elective surgery, with an aim to attenuate the surgical stress response and energy loss, improve the organ function, reduce postoperative complications and the time required for full recovery. ERAS was first applied in the colorectal surgery, and gradually expanded to other surgical areas. As for ERAS in the gastric surgery, the safety and efficacy have been proved preli- minarily by evidence-based medicine. However, there is still con- troversy about the individual items of the ERAS programs due to limited studies. Recent publications of the 2014 consensus guide- lines for enhanced recovery after gastrectomy Enhanced Recovery After Surgery （ ERAS ） Society recommendations that was eom- posed by the ERAS Society indieated the developing direetion of ERAS, and also updated perioperative praetiee to each medieal unit implementing ERAS. Meanwhile, general principles （guideline or consensus） and patients＇ conditions should be eombinedclosely into clinical practice. Since gastric cancer surgery is complex and patients＇ conditions are var/ous, further research may focus on individualized ERAS. In the further study, more high-quality randomized clinical trials with single-component administration in fast recovery settings need to reach more defi- nite conclusions and recommendations. Furthermore, attentions should be paid to enhance patients＇ compliance with the ERAS items.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2015年第1期33-37,共5页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金（81171857）
关键词
胃肿瘤
加速康复外科
胃切除术
围术期
Gastric neoplasms
Enhanced recoveryafter surgery
Gastrectomy
Periope-rative period
