加速康復外科術后結局評價指標研究進展_West China Medical Journal

Authors：

鄧欣 ^1,2 ,  寧寧 ¹ , 陳佳麗 ¹ , 張月兒 ¹ , 李佩芳 ¹

1. ;
2. ;

Corresponding?author：

寧寧, Email: gkningning@126.com

Keywords：

加速康復外科; 術后結局; 評價指標; 患者報告結局; 醫生報告結局

DOI：

10.7507/1002-0179.201707166

Video：

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加速康復外科（enhanced recovery after surgery，ERAS）是圍手術期采用多模式優化，內在目的為減輕患者圍手術期應激反應，外在目的為減少患者術后并發癥及縮短住院時間，以改善外科患者術后恢復效果，提高患者滿意度。該文簡要介紹了 ERAS 國內外發展近況，針對如何有效評價 ERAS 方案的效果從 2 個方面進行闡述，一方面是醫生報告預后結局評價，分別為住院時間、術后并發癥、術后應激反應等評價指標，另一方面是患者報告結局，分別為疼痛、患者滿意度、患者生存質量等評價指標對國內外現狀進行總結。并提出展望運用患者報告結局工具建立長期術后結局報告系統及運用理論框架和模型系統分析 ERAS 方案有效性，望之后有學者能拓展相關研究領域，為 ERAS 的效果提供更科學的評價系統。

Citation： 鄧欣, 寧寧, 陳佳麗, 張月兒, 李佩芳. 加速康復外科術后結局評價指標研究進展. West China Medical Journal, 2017, 32(9): 1362-1365. doi: 10.7507/1002-0179.201707166 Copy

1.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
2.	李幼生. 加速康復外科: 現狀及今后需要關注的問題. 中華醫學雜志, 2017, 97(4): 244-247.
3.	Slim K. Fast-track surgery: the next revolution in surgical care following laparoscopy. Colorectal Dis, 2011, 13(5): 478-480.
4.	Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS^@) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
5.	Zhou T, Wu XT, Zhou YJ, et al. Early removing gastrointestinal decompression and early oral feeding improve patients’ rehabilitation after colorectostomy. World J Gastroenterol, 2006, 12(15): 2459-2463.
6.	中華醫學會腸外腸內營養學分會加速康復外科協作組. 結直腸手術應用加速康復外科中國專家共識 (2015 版) 中華普通外科學文獻: 電子版, 2015, 9(5): 335-337.
7.	中國醫師協會麻醉學醫師分會. 促進術后康復的麻醉管理專家共識. 中華麻醉學雜志, 2015, 35(2): 141-148.
8.	周宗科, 翁習生, 曲鐵兵, 等. 中國髖、膝關節置換術加速康復——圍術期管理策略專家共識. 中華骨與關節外科雜志, 2016, 9(1): 1-9.
9.	中國加速康復外科專家組. 中國加速康復外科圍手術期管理專家共識 (2016) 中華外科雜志, 2016, 54(6): 413-418.
10.	王輝, 王堅. 加速康復外科理念指導下的日間腹腔鏡膽囊切除術 1400 例分析. 肝膽胰外科雜志, 2017, 29(1): 6-9.
11.	任娜娜, 張詠梅, 劉艾, 等. 加速康復外科護理對胃大部切除術患者康復效果影響的 Meta 分析. 護理學雜志, 2015, 30(16): 98-102.
12.	宋偉, 鄒書兵. 加速康復外科在肝臟手術圍手術期應用的 Meta 分析. 中國普通外科雜志, 2016, 25(1): 115-125.
13.	常志泳, 包倪榮, 趙建寧, 等. 加速康復外科理論在高齡股骨頸骨折圍手術期的初步應用. 中國矯形外科雜志, 2013, 21(2): 123-126.
14.	Khuri SF, Henderson WG, Depalma RG, et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg, 2005, 242(3): 326-343.
15.	Spanjersberg WR, Van Sambeeck JD, Bremers A, et al. Systematic review and meta-analysis for laparoscopic versus open colon surgery with or without an ERAS programme. Surg Endosc, 2015, 29(12): 3443-3453.
16.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
17.	王希, 黃建華, 羅浩元, 等. 加速康復外科對腹腔鏡輔助結直腸癌根治術后患者免疫功能及近期結局的影響. 腹腔鏡外科雜志, 2016, 21(11): 837-841.
18.	王東升, 仲蓓, 孔營, 等. 加速康復外科對胃癌病人術后近期臨床結局的影響. 腸外與腸內營養, 2010, 17(6): 338-340, 344.
19.	Paton F, Chambers D, Wilson P, et al. Effectiveness and implementation of enhanced recovery after surgery programmes: a rapid evidence synthesis. BMJ Open, 2014, 4(7): e005015.
20.	Thanh NX, Chuck AW, Wasylak T, et al. An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta. Can J Surg, 2016, 59(6): 415-421.
21.	Nelson G, Kalogera E, Dowdy SC. Enhanced recovery pathways in gynecologic oncology. Gynecol Oncol, 2014, 135(3): 586-594.
22.	Nelson G, Kiyang LN, Chuck A, et al. Cost impact analysis of Enhanced Recovery After Surgery program implementation in Alberta colon cancer patients. Curr Oncol, 2016, 23(3): e221-e227.
23.	Jones EL, Wainwright TW, Foster JD, et al. A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery. Ann R Coll Surg Engl, 2014, 96(2): 89-94.
24.	Morrison RS, Magaziner J, Mclaughlin MA, et al. The impact of post-operative pain on outcomes following hip fracture. Pain, 2003, 103(3): 303-311.
25.	蔡宇, 周華軍, 程文俊, 等. 加速康復外科聯合標準化康復路徑在全髖關節置換術治療老年股骨頸骨折患者中的應用. 中華創傷骨科雜志, 2016, 18(8): 673-678.
26.	Ahmed K, Kyte D, Keeley T, et al. Systematic evaluation of patient-reported outcome (PRO) protocol content and reporting in UK cancer clinical trials: the EPiC study protocol. BMJ Open, 2016, 6(9): e012863.
27.	張艷宏, 劉保延, 何麗云, 等. 病人報告的臨床結局研究與實際應用. 中西醫結合學報, 2008, 6(11): 1101-1104.
28.	劉巧君. " 基于高血壓患者報告的臨床結局評價量表”的編制與評價. 太原: 山西醫科大學, 2011.
29.	Husted H, Hansen HC, Holm G, et al. What determines length of stay after total hip and knee arthroplasty? A nationwide study in Denmark. Arch Orthop Trauma Surg, 2010, 130(2): 263-268.
30.	Larsen K, Hansen TB, S?balle K, et al. Patient-reported outcome after fast-track hip arthroplasty: a prospective cohort study. Health Qual Life Outcomes, 2010, 8: 144.
31.	Feldman LS, Lee L, Fiore J. What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?. Can J Anaesth, 2015, 62(2): 120-130.
32.	Neville A, Lee L, Antonescu I, et al. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg, 2014, 101(3): 159-170.
33.	Makhni EC, Meadows M, Hamamoto JT, et al. Patient Reported Outcomes Measurement Information System (PROMIS) in the upper extremity: the future of outcomes reporting?. J Shoulder Elbow Surg, 2017, 26(2): 352-357.
34.	Michie S, Johnston M, Abraham C, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care, 2005, 14(1): 26-33.
35.	Gramlich LM, Sheppard CE, Wasylak T, et al. Implementation of enhanced recovery after surgery: a strategy to transform surgical care across a health system. Implement Sci, 2017, 12(1): 67.
36.	Francis JJ, O’Connor D, Curran J. Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implement Sci, 2012, 7: 35.

1. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
2. 李幼生. 加速康復外科: 現狀及今后需要關注的問題. 中華醫學雜志, 2017, 97(4): 244-247.
3. Slim K. Fast-track surgery: the next revolution in surgical care following laparoscopy. Colorectal Dis, 2011, 13(5): 478-480.
4. Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS^@) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
5. Zhou T, Wu XT, Zhou YJ, et al. Early removing gastrointestinal decompression and early oral feeding improve patients’ rehabilitation after colorectostomy. World J Gastroenterol, 2006, 12(15): 2459-2463.
6. 中華醫學會腸外腸內營養學分會加速康復外科協作組. 結直腸手術應用加速康復外科中國專家共識 (2015 版) 中華普通外科學文獻: 電子版, 2015, 9(5): 335-337.
7. 中國醫師協會麻醉學醫師分會. 促進術后康復的麻醉管理專家共識. 中華麻醉學雜志, 2015, 35(2): 141-148.
8. 周宗科, 翁習生, 曲鐵兵, 等. 中國髖、膝關節置換術加速康復——圍術期管理策略專家共識. 中華骨與關節外科雜志, 2016, 9(1): 1-9.
9. 中國加速康復外科專家組. 中國加速康復外科圍手術期管理專家共識 (2016) 中華外科雜志, 2016, 54(6): 413-418.
10. 王輝, 王堅. 加速康復外科理念指導下的日間腹腔鏡膽囊切除術 1400 例分析. 肝膽胰外科雜志, 2017, 29(1): 6-9.
11. 任娜娜, 張詠梅, 劉艾, 等. 加速康復外科護理對胃大部切除術患者康復效果影響的 Meta 分析. 護理學雜志, 2015, 30(16): 98-102.
12. 宋偉, 鄒書兵. 加速康復外科在肝臟手術圍手術期應用的 Meta 分析. 中國普通外科雜志, 2016, 25(1): 115-125.
13. 常志泳, 包倪榮, 趙建寧, 等. 加速康復外科理論在高齡股骨頸骨折圍手術期的初步應用. 中國矯形外科雜志, 2013, 21(2): 123-126.
14. Khuri SF, Henderson WG, Depalma RG, et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg, 2005, 242(3): 326-343.
15. Spanjersberg WR, Van Sambeeck JD, Bremers A, et al. Systematic review and meta-analysis for laparoscopic versus open colon surgery with or without an ERAS programme. Surg Endosc, 2015, 29(12): 3443-3453.
16. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
17. 王希, 黃建華, 羅浩元, 等. 加速康復外科對腹腔鏡輔助結直腸癌根治術后患者免疫功能及近期結局的影響. 腹腔鏡外科雜志, 2016, 21(11): 837-841.
18. 王東升, 仲蓓, 孔營, 等. 加速康復外科對胃癌病人術后近期臨床結局的影響. 腸外與腸內營養, 2010, 17(6): 338-340, 344.
19. Paton F, Chambers D, Wilson P, et al. Effectiveness and implementation of enhanced recovery after surgery programmes: a rapid evidence synthesis. BMJ Open, 2014, 4(7): e005015.
20. Thanh NX, Chuck AW, Wasylak T, et al. An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta. Can J Surg, 2016, 59(6): 415-421.
21. Nelson G, Kalogera E, Dowdy SC. Enhanced recovery pathways in gynecologic oncology. Gynecol Oncol, 2014, 135(3): 586-594.
22. Nelson G, Kiyang LN, Chuck A, et al. Cost impact analysis of Enhanced Recovery After Surgery program implementation in Alberta colon cancer patients. Curr Oncol, 2016, 23(3): e221-e227.
23. Jones EL, Wainwright TW, Foster JD, et al. A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery. Ann R Coll Surg Engl, 2014, 96(2): 89-94.
24. Morrison RS, Magaziner J, Mclaughlin MA, et al. The impact of post-operative pain on outcomes following hip fracture. Pain, 2003, 103(3): 303-311.
25. 蔡宇, 周華軍, 程文俊, 等. 加速康復外科聯合標準化康復路徑在全髖關節置換術治療老年股骨頸骨折患者中的應用. 中華創傷骨科雜志, 2016, 18(8): 673-678.
26. Ahmed K, Kyte D, Keeley T, et al. Systematic evaluation of patient-reported outcome (PRO) protocol content and reporting in UK cancer clinical trials: the EPiC study protocol. BMJ Open, 2016, 6(9): e012863.
27. 張艷宏, 劉保延, 何麗云, 等. 病人報告的臨床結局研究與實際應用. 中西醫結合學報, 2008, 6(11): 1101-1104.
28. 劉巧君. " 基于高血壓患者報告的臨床結局評價量表”的編制與評價. 太原: 山西醫科大學, 2011.
29. Husted H, Hansen HC, Holm G, et al. What determines length of stay after total hip and knee arthroplasty? A nationwide study in Denmark. Arch Orthop Trauma Surg, 2010, 130(2): 263-268.
30. Larsen K, Hansen TB, S?balle K, et al. Patient-reported outcome after fast-track hip arthroplasty: a prospective cohort study. Health Qual Life Outcomes, 2010, 8: 144.
31. Feldman LS, Lee L, Fiore J. What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?. Can J Anaesth, 2015, 62(2): 120-130.
32. Neville A, Lee L, Antonescu I, et al. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg, 2014, 101(3): 159-170.
33. Makhni EC, Meadows M, Hamamoto JT, et al. Patient Reported Outcomes Measurement Information System (PROMIS) in the upper extremity: the future of outcomes reporting?. J Shoulder Elbow Surg, 2017, 26(2): 352-357.
34. Michie S, Johnston M, Abraham C, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care, 2005, 14(1): 26-33.
35. Gramlich LM, Sheppard CE, Wasylak T, et al. Implementation of enhanced recovery after surgery: a strategy to transform surgical care across a health system. Implement Sci, 2017, 12(1): 67.
36. Francis JJ, O’Connor D, Curran J. Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implement Sci, 2012, 7: 35.

West China Medical Journal

加速康復外科術后結局評價指標研究進展

Abstract Full text Figures/Tables Video References Cited by

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