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本文引用的文献

1
Enhanced recovery after surgery (ERAS) program for elderly patients with short-level lumbar fusion.老年短节段腰椎融合术后加速康复外科(ERAS)方案。
J Orthop Surg Res. 2020 Aug 6;15(1):299. doi: 10.1186/s13018-020-01814-3.
2
A systematic review of best practices for the perioperative management of abdominal sacrocolpopexy.经阴道式全子宫切除术和阴道顶端骶骨固定术的围手术期管理最佳实践的系统评价。
Neurourol Urodyn. 2020 Jun;39(5):1264-1275. doi: 10.1002/nau.24411. Epub 2020 May 29.
3
Minimizing the impact of colorectal surgery in the older patient: The role of enhanced recovery programs in older patients.最大限度减少老年患者结直肠手术的影响:老年患者强化康复方案的作用。
Eur J Surg Oncol. 2020 Mar;46(3):338-343. doi: 10.1016/j.ejso.2019.12.018. Epub 2020 Jan 2.
4
Frailty in the older person undergoing elective surgery: a trigger for enhanced multidisciplinary management - a narrative review.老年人择期手术中的脆弱性:增强多学科管理的触发因素——叙述性综述。
ANZ J Surg. 2020 Mar;90(3):222-229. doi: 10.1111/ans.15633. Epub 2020 Jan 9.
5
Transversus Abdominis Plane Blocks in Laparoscopic Colorectal Surgery: Better Pain Control and Patient Outcomes with Liposomal Bupivacaine than Bupivacaine.腹腔镜结直肠手术中的腹横肌平面阻滞:与布比卡因相比,脂质体布比卡因能更好地控制疼痛并改善患者预后。
Am Surg. 2019 Sep 1;85(9):1013-1016.
6
Enhanced recovery after surgery (ERAS) protocol reduces perioperative narcotic requirement and length of stay in patients undergoing mastectomy with implant-based reconstruction.术后加速康复(ERAS)方案可减少接受乳房切除术和基于植入物的重建手术患者的围手术期阿片类药物需求和住院时间。
Am J Surg. 2020 Jul;220(1):147-152. doi: 10.1016/j.amjsurg.2019.10.007. Epub 2019 Oct 12.
7
Enhanced recovery after surgery versus traditional care in total pelvic floor reconstruction surgery with transvaginal mesh.经阴道网片全盆底重建术中术后加速康复与传统护理的比较。
Int J Gynaecol Obstet. 2020 Jan;148(1):107-112. doi: 10.1002/ijgo.12991. Epub 2019 Oct 27.
8
Canadian consensus statement: enhanced recovery after surgery in bariatric surgery.加拿大共识声明:减重手术中的术后快速康复。
Surg Endosc. 2020 Mar;34(3):1366-1375. doi: 10.1007/s00464-019-06911-x. Epub 2019 Jun 17.
9
Preoperative patient preparation in enhanced recovery pathways.强化康复路径中的术前患者准备
J Anaesthesiol Clin Pharmacol. 2019 Apr;35(Suppl 1):S14-S23. doi: 10.4103/joacp.JOACP_54_18.
10
Preoperative Frailty Evaluation: A Promising Risk-stratification Tool in Older Adults Undergoing General Surgery.术前虚弱评估:老年普外科手术患者有前途的风险分层工具。
Clin Ther. 2019 Mar;41(3):387-399. doi: 10.1016/j.clinthera.2019.01.014. Epub 2019 Feb 22.

手术后加速康复:老年女性视角

Enhanced Recovery after Surgery: Perspective in Elder Women.

作者信息

Gupta Sandhya, Rane Ajay

机构信息

Department of Obstetrics and Gynaecology, James Cook University, Townsville, Australia.

出版信息

J Midlife Health. 2021 Apr-Jun;12(2):93-98. doi: 10.4103/jmh.jmh_89_21. Epub 2021 Jul 27.

DOI:10.4103/jmh.jmh_89_21
PMID:34526741
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8409712/
Abstract

Enhanced recovery after surgery (ERAS) is a multimodal convention first reported for colorectal and gynecologic procedures. The main benefits have been a shorter length of stay and reduced complications, leading to improved clinical outcomes and cost savings substantially. With increase in life expectancy, recent years has shown a significant rise in advanced age population, and similarly, a rise in age-related disorders requiring surgical management. Due to pathophysiological and metabolic changes in geriatric age group with increased incidence of medical comorbidities, there is higher risk of enhanced surgical stress response with undesirable postoperative morbidity, complications, prolonged immobility, and extended convalescence. The feasibility and effectiveness of ERAS protocols have been well researched and documented among all age groups, including the geriatric high-risk population. Adhering to ERAS protocols after colorectal surgery showed no significant difference in postoperative complications, hospital stay, or readmission rate among various age groups. A recent report mentions the safety and benefits following ERAS guidelines with reduced length of stay in elderly patients with short-level lumbar fusion surgery. The concept of prehabilitation has evolved as an integral part of ERAS to build up physiological reserve, especially in geriatric high-risk group, and to adapt better to surgical stress. High levels of compliance with ERAS interventions combined with prehabilitation can be achieved when a dedicated multidisciplinary team is involved in care of these high-risk patients.

摘要

术后加速康复(ERAS)是一种多模式方案,最初是针对结直肠和妇科手术报道的。其主要益处包括缩短住院时间和减少并发症,从而显著改善临床结局并节省成本。随着预期寿命的增加,近年来老年人口显著增加,同样,需要手术治疗的与年龄相关的疾病也有所增加。由于老年人群存在病理生理和代谢变化,且合并症发生率增加,手术应激反应增强的风险更高,术后会出现不良发病率、并发症、长期制动和康复期延长。ERAS方案在包括老年高危人群在内的所有年龄组中的可行性和有效性已得到充分研究和记录。结直肠手术后遵循ERAS方案,各年龄组在术后并发症、住院时间或再入院率方面无显著差异。最近一份报告提到,老年患者进行短节段腰椎融合手术时,遵循ERAS指南具有安全性和益处,可缩短住院时间。术前康复的概念已演变为ERAS的一个组成部分,以建立生理储备,特别是在老年高危人群中,并更好地适应手术应激。当一个专门的多学科团队参与这些高危患者的护理时,可以实现对ERAS干预措施的高度依从性并结合术前康复。