中国实用外科杂志

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从加速康复外科到预康复——理念更新与临床实践模式转变

李幼生   

  1. 上海交通大学医学院附属第九人民医院普通外科,上海 200011
  • 出版日期:2024-02-01

  • Online:2024-02-01

摘要: 加速康复外科(ERAS)可有效提高手术安全性、缩短住院时间、降低医疗费用。ERAS主要强调围手术期及术后干预。然而,术前病人各项功能及相关能力差与术后并发症和死亡率增加有关,提高病人术前各项功能及相关能力可以改善术后恢复。包括运动、营养和心理社会成分在内的术前多模式预康复可作为对ERAS方案的有益补充,目标是增强病人的能力、降低术后发病率,提高术后恢复率,最终通过持续行为改变和并发症管理以期改善病人长期预后。

关键词: 加速康复外科, 预康复, 衰弱, 医学营养治疗

Abstract: From enhanced recovery after surgery to prehabilitation: the new concepts and clinical practice        LI You-sheng.Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
Abstract    Enhanced recovery after surgery (ERAS) results in prioritized patient safety, optimized length of hospital stay, and decreased hospital costs. ERAS protocols are mainly applied to peri- and postoperatively. However, poor functional capacity preoperatively is associated with postoperative complications and increased mortality. Increasing the functional capacity preoperatively may result in an improved recovery after surgery. Multimodal prehabilitation interventions that include exercise, nutrition, and psychosocial components can be implemented before surgery. The goal of prehabilitation complemented ERAS protocols is to empower patients, reduce the risk of postoperative morbidity, improve the rate of postoperative recovery, and ultimately, through sustained behavioral change and improved management of comorbidities, improve long-term health outcomes.

Key words: enhanced recovery after surgery, prehabilitation, frailty, medical nutrition therapy