From Enhanced Recovery after Surgery to Day-case Surgery: Interpretation on Guidelines for Day-case Surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery
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摘要: 日间手术的逐步广泛开展和加速康复外科围手术期管理理念的不断推进, 均是为了促进患者快速康复, 使患者更为安全地度过围手术期。英国2019年日间手术指南的发布, 有助于我们更好地了解日间手术围手术期管理过程中的临床实践方法和管理路径, 对指导临床医生如何安全地开展日间手术具有重要指导价值。本文从加速康复外科理念的高度, 就指南更新内容进行循证医学证据的深度挖掘, 进一步阐明日间手术临床实践的发展方向。Abstract: The fast development of day-case surgery and the continuous advancement of enhanced recovery after surgery(ERAS)are all aimed at improving the quality of recovery after surgery so that patients can go through the perioperative period more smoothly and safely. The publication of Guidelines for Day-case Surgery 2019:Guidelines from the Association of Anaesthetists and the British Association of Day Surgery, as important guidance for clinicians to safely perform day-case surgery, will help us to better understand the clinical practice and the perioperative management pathway of day-case surgery. The interpretation made a deeply evidence-based exploration in the updated contents of the guidelines, and further disclosed the development direction of day-case surgery from the perspective of ERAS.
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Key words:
- day-case surgery /
- enhanced recovery after surgery /
- guideline /
- interpretation
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表 1 常见日间手术的疼痛分级
疼痛级别 常见手术 A(无痛) 麻醉下耳道检查、膀胱镜检、牙齿修复 B(轻度) 白内障手术、宫内节育器置入、前列腺活检、粉瘤切除、肠镜、皮损切除、尿道手术 C(中度) 肛周手术、牙根尖切除术、关节镜、腋窝清扫、乳腺结节切除、掌腱膜挛缩手术、腕管减压术、宫颈/外阴手术、宫腔镜/诊刮术、中耳手术、麻醉下激素注射、尿道悬吊术、曲张静脉剥脱术、结扎术、非智齿拔除 D(重度) 前交叉韧带重建、包皮环切术、子宫内膜切除术、腹腔镜、痔切除术、疝修补、关节融合/截骨术、肩关节手术、斜视手术、睾丸手术、扁桃体切除、智齿拔除、洗牙 -
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