Anaesthesia and Critical Care Research Unit, University Hospitals Southampton NHS Foundation Trust, UK.
Curr Opin Crit Care. 2012 Aug;18(4):385-92. doi: 10.1097/MCC.0b013e3283558968.
The aim of this review is to summarize important publications in enhanced recovery during 2010-2011 and to highlight key themes. Specifically, we focus on updated systematic reviews of high-quality clinical trials of enhanced recovery in colorectal surgery, exemplar studies of enhanced recovery in other specialties, and exploration of which elements of the enhanced recovery package might be associated with improved patient outcome.
An expanding evidence base of clinical trials and implementation evaluations supports the effectiveness of enhanced recovery programmes in improving outcome following major elective surgery. The majority of this literature derives from the study of patients undergoing colorectal surgery, but increasingly enhanced recovery is spreading to other surgical specialties. The combination of reduced length of hospital stay (a surrogate for morbidity) with no increase in readmissions to hospital suggests that morbidity is reduced with enhanced recovery. Inconsistency in morbidity reporting limits the value of pooling data between studies, but within study comparisons in general support this conclusion. Patients adhering to an enhanced recovery programme return to normal function faster than those following traditional care pathways.
Enhanced recovery adoption is likely to continue to grow (range of specialties and penetration within specialties). This progression is supported by the available published data.
本综述旨在总结 2010-2011 年期间加速康复的重要文献，并突出重点主题。具体而言，我们专注于结直肠外科加速康复的高质量临床试验的更新系统评价、其他专业的加速康复范例研究，以及探索加速康复方案的哪些要素可能与改善患者预后相关。
越来越多的临床试验和实施评估的证据基础支持了加速康复方案在改善主要择期手术后结局方面的有效性。该文献的大部分来自于接受结直肠手术患者的研究，但加速康复越来越多地扩展到其他外科专业。住院时间（发病率的替代指标）缩短且无再入院增加表明，加速康复降低了发病率。发病率报告的不一致限制了对研究间数据的汇总价值，但一般而言，研究内比较支持这一结论。遵循加速康复方案的患者比接受传统护理路径的患者恢复正常功能的速度更快。
加速康复的采用可能会继续增长（涵盖的专业和专业内的渗透程度）。这一进展得到了现有已发表数据的支持。
