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全髋关节置换术围手术期路径的现代化:加速康复外科-门诊协议的实施

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol.

作者信息

Sivaloganathan Sivan, Blakeney William G, Vendittoli Pascal-André

机构信息

Surgery Department, Hôpital Maisonneuve-Rosemont, Montreal University, 5415 Boulevard de l'Assomption, Montreal, QC H1T 2M4, Canada.

Department of Orthopedic Surgery, Royal Perth Hospital, Perth, WA 6000, Australia.

出版信息

J Clin Med. 2022 Jun 8;11(12):3293. doi: 10.3390/jcm11123293.

Abstract

Pressure to reduce healthcare costs, limited hospital availability along with improvements in surgical technique and perioperative care motivated many centers to focus on outpatient pathway implementation. However, in many short-stay protocols, the focus has shifted away from aiming to reduce complications and improved rehabilitation, to using length of stay as the main factor of success. To improve patient outcomes and maintain safety, the best way to implement a successful outpatient program would be to combine it with the principles of enhanced recovery after surgery (ERAS), and to improve patient recovery to a level where the patient is able to leave the hospital sooner. This article delivers a case for modernizing total hip arthroplasty perioperative pathways by implementing ERAS-outpatient protocols.

摘要

降低医疗成本的压力、医院资源有限,以及手术技术和围手术期护理的改进,促使许多中心将重点放在门诊路径的实施上。然而,在许多短期住院方案中,重点已从旨在减少并发症和改善康复,转向将住院时间作为成功的主要因素。为了改善患者预后并维持安全性,实施成功的门诊项目的最佳方法是将其与术后加速康复(ERAS)原则相结合,并将患者康复改善到患者能够更快出院的水平。本文通过实施ERAS门诊方案,为全髋关节置换术围手术期路径的现代化提供了一个实例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56d9/9224899/b23b6205bf44/jcm-11-03293-g001.jpg

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