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Enhanced Recovery Pathways: the Direction in the Future
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摘要: 加速康复临床路径(enhanced recovery pathways, ERPs)的引入促使围手术期医疗模式发生了巨大转变, 现已广泛应用于各外科中, 并取得了不俗成效。加速康复的原则为促进正常功能恢复、全面的围手术期干预、多学科参与和教育以及基于循证医学证据的干预。ERPs最先应用于结直肠和心脏手术, 现已被整形外科、泌尿外科和妇产科等各外科专业广泛采用, 但其在高龄、衰弱或急诊手术患者中的应用仍存在局限性, 可针对这些患者的实际情况进行改良。本文就ERPs的基本原则、应用现状及未来发展方向展开讨论。Abstract: The introduction of enhanced recovery pathways has led to a considerable shift in the paradigm of perioperative care, which are now widely implemented in a variety of surgical specialties with large positive results. The principles of enhanced recovery are promoting recovery of normal functions, comprehensive perioperative interventions, multidisciplinary involvement and education, and evidence-based intervention. Enhanced recovery pathways were initially introduced in colorectal and cardiac surgery, and have been adopted amongst orthopedics, urology, obstetrics and gynecology, and other surgical specialties. Limitations for older or more frail patients, or patients undergoing emergent surgeries should be considered, and the pathways could be modified for those patients. In this review, we discussed the principles and status of enhanced recovery pathways as well as the room for further development.
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Key words:
- enhanced recovery /
- principle /
- development
利益冲突 无翻译: 赵梦芸, 裴丽坚 (北京协和医院麻醉科)审校: 黄宇光 (北京协和医院麻醉科) -
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