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为接受髋关节或膝关节重建手术的肿瘤患者制定术后加速康复计划。

Developing an enhanced recovery after surgery program for oncology patients who undergo hip or knee reconstruction surgery.

作者信息

Bourazani Maria, Asimakopoulou Eleni, Magklari Chrysseida, Fyrfiris Nikolaos, Tsirikas Ioannis, Diakoumis Giakoumis, Kelesi Martha, Fasoi Georgia, Kormas Theodoros, Lefaki Gunhild

机构信息

Department of Anesthesiology, "Saint-Savvas" Anticancer Hospital of Athens, Athens 11522, Attica, Greece.

Physiotherapy Center, Egaleo, Athens 12242, Attica, Greece.

出版信息

World J Orthop. 2021 Jun 18;12(6):346-359. doi: 10.5312/wjo.v12.i6.346.

Abstract

Enhanced recovery after surgery (ERAS) protocols are applied in orthopedic surgery and are intended to reduce perioperative stress by implementing combined evidence-based practices with the cooperation of various health professionals as an interdisciplinary team. ERAS pathways include pre-operative patient counselling, regional anesthesia and analgesia techniques, post-operative pain management, early mobilization and early feeding. Studies have shown improvement in the recovery of patients who followed an ERAS program after hip or knee arthroplasty, compared with those who followed a traditional care approach. ERAS protocols reduce post-operative stress, contribute to rapid recovery, shorten length of stay (LOS) without increasing the complications or readmissions, improve patient satisfaction and decrease the hospital costs. We suggest that the ERAS pathway could reduce the LOS in hospital for patients undergoing total hip replacement or total knee replacement. These programs require good organization and handling by the multidisciplinary team. ERAS programs increase patient's satisfaction due to their active participation which they experience as personalized treatment. The aim of the study was to develop an ERAS protocol for oncology patients who undergo bone reconstruction surgeries using massive endoprosthesis, with a view to improving the surgical outcomes.

摘要

术后加速康复(ERAS)方案应用于骨科手术,旨在通过跨学科团队中各医疗专业人员的合作实施综合循证实践,以减轻围手术期应激。ERAS路径包括术前患者咨询、区域麻醉和镇痛技术、术后疼痛管理、早期活动和早期进食。研究表明,与采用传统护理方法的患者相比,接受髋关节或膝关节置换术后遵循ERAS方案的患者恢复情况有所改善。ERAS方案可减轻术后应激,促进快速康复,缩短住院时间(LOS),且不增加并发症或再入院率,提高患者满意度并降低医院成本。我们认为,ERAS路径可缩短接受全髋关节置换术或全膝关节置换术患者的住院时间。这些方案需要多学科团队进行良好的组织和处理。ERAS方案因其积极参与而增加患者满意度,患者将其体验为个性化治疗。本研究的目的是为接受使用大型内置假体进行骨重建手术的肿瘤患者制定ERAS方案,以期改善手术效果。

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Enhanced recovery pathways in orthopedic surgery.骨科手术中的加速康复路径
J Anaesthesiol Clin Pharmacol. 2019 Apr;35(Suppl 1):S35-S39. doi: 10.4103/joacp.JOACP_35_18.

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