对于外科病人实施规范化的围手术期管理仍然是亟待解决的问题。病人导向的围手术期的液体管理需要在理念和实践中得到外科医生的接受。对于创伤与严重感染病人，在输注血液制品的指征方面存在明显差别，不应浑淆。深静脉血栓的抗凝问题和脓毒症的抗凝治疗有多方面的不同，需在病理生理机制、治疗目的及临床评估等加以区别；对于普外科术后普遍存在的消化道功能障碍问题，目前仍没有理想的评估标准，现存指南仍有许多进一步完善的空间。

A few questions on standardized perioperative management for general surgical patients        MA Xiao-chun. Intensive Care Unit，the First Affiliated Hospital of China Medical University，Shenyang 110001，China
Abstract    It is important to implement standardized perioperative management regularly and individually for surgical patients. First of all，there is no unified concept about the exact timing and volume of resuscitation fluids infused after operation. Especially，major trauma and severe sepsis patients should be treated differentially in the transfusion of blood products. Secondly，it is really a clinical problem of preventing deep vein thrombosis for postoperative patients who are in bed for a long time，which should be differentiated from the anticoagulation therapy for sepsis patients. In the end，for gastrointestinal dysfunction of general surgical patients, it suggests to assess gastrointestinal function classically according to guideline.