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加速胃肠功能康复的麻醉和围手术期策略

朱阿芳 黄宇光

朱阿芳, 黄宇光. 加速胃肠功能康复的麻醉和围手术期策略[J]. 协和医学杂志, 2018, 9(6): 496-500. doi: 10.3969/j.issn.1674-9081.2018.06.004
引用本文: 朱阿芳, 黄宇光. 加速胃肠功能康复的麻醉和围手术期策略[J]. 协和医学杂志, 2018, 9(6): 496-500. doi: 10.3969/j.issn.1674-9081.2018.06.004
A-fang ZHU, Yu-guang HUANG. Strategies of Anesthesia and Perioperative Recovery to Enhance the Gastrointestinal Function[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(6): 496-500. doi: 10.3969/j.issn.1674-9081.2018.06.004
Citation: A-fang ZHU, Yu-guang HUANG. Strategies of Anesthesia and Perioperative Recovery to Enhance the Gastrointestinal Function[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(6): 496-500. doi: 10.3969/j.issn.1674-9081.2018.06.004

加速胃肠功能康复的麻醉和围手术期策略

doi: 10.3969/j.issn.1674-9081.2018.06.004
基金项目: 

国家自然科学基金 81671098

详细信息
    通讯作者:

    黄宇光  电话:010-69152100,E-mail: garybeijing@163.com

  • 中图分类号: R459.4

Strategies of Anesthesia and Perioperative Recovery to Enhance the Gastrointestinal Function

More Information
  • 摘要: 加速康复外科(enhanced recovery after surgery, ERAS)通过整合一系列围手术期优化策略, 以期降低患者应激反应、减少术后并发症及缩短住院时间, 最终达到加速患者康复的目标。就目前国内外研究现状而言, ERAS应用最多最成功的领域依然是胃肠外科, 而诸如术前未纠正的营养风险状态、术前长时间禁食水、围手术期容量过负荷及过量使用阿片类药物等各项管理不当的麻醉和围手术期策略均可能对胃肠功能造成一定程度损害, 进而增加术后并发症、延长住院时间并阻碍康复进程。因此规范ERAS中与胃肠功能相关的各项麻醉和围手术期策略, 对改善患者结局具有十分重要的意义。
  • [1] Thiele RH, Raghunathan K, Brudney CS, et al. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery[J]. Perioper Med (Lond), 2016, 5:24. doi:  10.1186/s13741-016-0049-9
    [2] McEvoy MD, Scott MJ, Gordon DB, et al. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery:part 1-from the preoperative period to PACU[J]. Perioper Med (Lond), 2017, 6:8. doi:  10.1186/s13741-017-0064-5
    [3] Scott MJ, McEvoy MD, Gordon DB, et al. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery:part 2-from PACU to the transition home[J]. Perioper Med (Lond), 2017, 6:7. doi:  10.1186/s13741-017-0063-6
    [4] Holubar SD, Hedrick T, Gupta R, et al. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery[J]. Perioper Med (Lond), 2017, 6:4. doi:  10.1186/s13741-017-0059-2
    [5] Moonesinghe SR, Grocott MPW, Bennett-Guerrero E, et al. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on measurement to maintain and improve quality of enhanced recovery pathways for elective colorectal surgery[J]. Perioper Med (Lond), 2017, 6:6. doi:  10.1186/s13741-017-0062-7
    [6] Wischmeyer PE, Carli F, Evans DC, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway[J]. Anesth Analg, 2018, 126:1883-1895. doi:  10.1213/ANE.0000000000002743
    [7] Hedrick TL, McEvoy MD, Mythen MMG, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on postoperative gastrointestinal dysfunction within an enhanced recovery pathway for elective colorectal surgery[J]. Anesth Analg, 2018, 126:1896-1907. http://www.ncbi.nlm.nih.gov/pubmed/29293183
    [8] Abola RE, Bennett-Guerrero E, Kent ML, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on patient-reported outcomes in an enhanced recovery pathway[J]. Anesth Analg, 2018, 126:1874-1882. doi:  10.1213/ANE.0000000000002758
    [9] Smith MD, McCall J, Plank L, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery[J]. Cochrane Database Syst Rev, 2014, 8:CD009161. doi:  10.1002/14651858.CD009161/full
    [10] American Society of Anesthesiologists Committee. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration:Application to Healthy Patients Undergoing Elective Procedures:An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration[J]. Anesthesiology, 2017, 126:376-393. doi:  10.1097/ALN.0000000000001452
    [11] Qureshi SH, Rizvi SI, Patel NN, et al. Meta-analysis of colloids versus crystalloids in critically ill, trauma and surgical patients[J]. Br J Surg, 2016, 103:14-26. doi:  10.1002/bjs.9943
    [12] 陈凛, 陈亚进, 董海龙, 等.中华医学会外科学分会, 中华医学会麻醉学分会.加速康复外科中国专家共识及路径管理指南(2018版)[J].中国实用外科杂志, 2018, 38:1-20. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgsywkzz201801001
    [13] 朱鸣雷, 黄宇光, 刘晓红, 等.老年患者围手术期管理北京协和医院专家共识[J].协和医学杂志, 2018, 9:36-41. doi:  10.3969/j.issn.1674-9081.2018.01.008
    [14] Williams JD, Wischmeyer PE. Assessment of perioperative nutrition practices and attitudes-A national survey of colorectal and GI surgical oncology programs[J]. Am J Surg, 2017, 213:1010-1018. doi:  10.1016/j.amjsurg.2016.10.008
    [15] Elia M, Normand C, Norman K, et al. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting[J]. Clin Nutr, 2016, 35:370-380. doi:  10.1016/j.clnu.2015.05.010
    [16] Gustafsson UO, Oppelstrup H, Thorell A, et al. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery:a retrospective cohort study[J]. World J Surg, 2016, 40:1741-1747. doi:  10.1007/s00268-016-3460-y
    [17] Kurz A, Sessler DI. Opioid-induced bowel dysfunction:pathophysiology and potential new therapies[J]. Drugs, 2003, 63:649-671. doi:  10.2165/00003495-200363070-00003
    [18] Gan TJ, Diemunsch P, Habib AS, et al. Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting[J]. Anesth Analg, 2014, 118:85-113. doi:  10.1213/ANE.0000000000000002
    [19] Ho YM, Smith SR, Pockney P, et al. A meta-analysis on the effect of sham feeding following colectomy:should gum chewing be included in enhanced recovery after surgery protocols?[J]. Dis Colon Rectum, 2014, 57:115-126. doi:  10.1097/DCR.0b013e3182a665be
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出版历程
  • 收稿日期:  2018-09-04
  • 刊出日期:  2018-11-30

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