加速康复外科术后结局评价指标研究进展_West China Medical Journal

Authors：

邓欣 ^1,2 ,  宁宁 ¹ , 陈佳丽 ¹ , 张月儿 ¹ , 李佩芳 ¹

1. ;
2. ;

Corresponding author：

宁宁, Email: gkningning@126.com

Keywords：

加速康复外科; 术后结局; 评价指标; 患者报告结局; 医生报告结局

DOI：

10.7507/1002-0179.201707166

Video：

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加速康复外科（enhanced recovery after surgery，ERAS）是围手术期采用多模式优化，内在目的为减轻患者围手术期应激反应，外在目的为减少患者术后并发症及缩短住院时间，以改善外科患者术后恢复效果，提高患者满意度。该文简要介绍了 ERAS 国内外发展近况，针对如何有效评价 ERAS 方案的效果从 2 个方面进行阐述，一方面是医生报告预后结局评价，分别为住院时间、术后并发症、术后应激反应等评价指标，另一方面是患者报告结局，分别为疼痛、患者满意度、患者生存质量等评价指标对国内外现状进行总结。并提出展望运用患者报告结局工具建立长期术后结局报告系统及运用理论框架和模型系统分析 ERAS 方案有效性，望之后有学者能拓展相关研究领域，为 ERAS 的效果提供更科学的评价系统。

Citation： 邓欣, 宁宁, 陈佳丽, 张月儿, 李佩芳. 加速康复外科术后结局评价指标研究进展. 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. 加速康复外科: 现状及今后需要关注的问题. 中华医学杂志, 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.	中华医学会肠外肠内营养学分会加速康复外科协作组. 结直肠手术应用加速康复外科中国专家共识 (2015 版) 中华普通外科学文献: 电子版, 2015, 9(5): 335-337.
7.	中国医师协会麻醉学医师分会. 促进术后康复的麻醉管理专家共识. 中华麻醉学杂志, 2015, 35(2): 141-148.
8.	周宗科, 翁习生, 曲铁兵, 等. 中国髋、膝关节置换术加速康复——围术期管理策略专家共识. 中华骨与关节外科杂志, 2016, 9(1): 1-9.
9.	中国加速康复外科专家组. 中国加速康复外科围手术期管理专家共识 (2016) 中华外科杂志, 2016, 54(6): 413-418.
10.	王辉, 王坚. 加速康复外科理念指导下的日间腹腔镜胆囊切除术 1400 例分析. 肝胆胰外科杂志, 2017, 29(1): 6-9.
11.	任娜娜, 张咏梅, 刘艾, 等. 加速康复外科护理对胃大部切除术患者康复效果影响的 Meta 分析. 护理学杂志, 2015, 30(16): 98-102.
12.	宋伟, 邹书兵. 加速康复外科在肝脏手术围手术期应用的 Meta 分析. 中国普通外科杂志, 2016, 25(1): 115-125.
13.	常志泳, 包倪荣, 赵建宁, 等. 加速康复外科理论在高龄股骨颈骨折围手术期的初步应用. 中国矫形外科杂志, 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.	车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
17.	王希, 黄建华, 罗浩元, 等. 加速康复外科对腹腔镜辅助结直肠癌根治术后患者免疫功能及近期结局的影响. 腹腔镜外科杂志, 2016, 21(11): 837-841.
18.	王东升, 仲蓓, 孔营, 等. 加速康复外科对胃癌病人术后近期临床结局的影响. 肠外与肠内营养, 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, 周华军, 程文俊, 等. 加速康复外科联合标准化康复路径在全髋关节置换术治疗老年股骨颈骨折患者中的应用. 中华创伤骨科杂志, 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.	张艳宏, 刘保延, 何丽云, 等. 病人报告的临床结局研究与实际应用. 中西医结合学报, 2008, 6(11): 1101-1104.
28.	刘巧君. " 基于高血压患者报告的临床结局评价量表”的编制与评价. 太原: 山西医科大学, 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, Søballe 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. 加速康复外科: 现状及今后需要关注的问题. 中华医学杂志, 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. 中华医学会肠外肠内营养学分会加速康复外科协作组. 结直肠手术应用加速康复外科中国专家共识 (2015 版) 中华普通外科学文献: 电子版, 2015, 9(5): 335-337.
7. 中国医师协会麻醉学医师分会. 促进术后康复的麻醉管理专家共识. 中华麻醉学杂志, 2015, 35(2): 141-148.
8. 周宗科, 翁习生, 曲铁兵, 等. 中国髋、膝关节置换术加速康复——围术期管理策略专家共识. 中华骨与关节外科杂志, 2016, 9(1): 1-9.
9. 中国加速康复外科专家组. 中国加速康复外科围手术期管理专家共识 (2016) 中华外科杂志, 2016, 54(6): 413-418.
10. 王辉, 王坚. 加速康复外科理念指导下的日间腹腔镜胆囊切除术 1400 例分析. 肝胆胰外科杂志, 2017, 29(1): 6-9.
11. 任娜娜, 张咏梅, 刘艾, 等. 加速康复外科护理对胃大部切除术患者康复效果影响的 Meta 分析. 护理学杂志, 2015, 30(16): 98-102.
12. 宋伟, 邹书兵. 加速康复外科在肝脏手术围手术期应用的 Meta 分析. 中国普通外科杂志, 2016, 25(1): 115-125.
13. 常志泳, 包倪荣, 赵建宁, 等. 加速康复外科理论在高龄股骨颈骨折围手术期的初步应用. 中国矫形外科杂志, 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. 车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
17. 王希, 黄建华, 罗浩元, 等. 加速康复外科对腹腔镜辅助结直肠癌根治术后患者免疫功能及近期结局的影响. 腹腔镜外科杂志, 2016, 21(11): 837-841.
18. 王东升, 仲蓓, 孔营, 等. 加速康复外科对胃癌病人术后近期临床结局的影响. 肠外与肠内营养, 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, 周华军, 程文俊, 等. 加速康复外科联合标准化康复路径在全髋关节置换术治疗老年股骨颈骨折患者中的应用. 中华创伤骨科杂志, 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. 张艳宏, 刘保延, 何丽云, 等. 病人报告的临床结局研究与实际应用. 中西医结合学报, 2008, 6(11): 1101-1104.
28. 刘巧君. " 基于高血压患者报告的临床结局评价量表”的编制与评价. 太原: 山西医科大学, 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, Søballe 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

加速康复外科术后结局评价指标研究进展

Abstract Full text Figures/Tables Video References Cited by

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