加速康复外科(enhanced recovery after surgery,ERAS)是基于循证医学依据的一系列围术期优化处理措施,以达到快速康复为目的[1]。ERAS通过减轻术后应激反应、合理管理<!--IIYITAG:8:tengtong-->疼痛<!--IIYITAG:/8:tengtong-->、早期恢复饮食和早期活动等措施来减少术后并发症,缩短术后住院时间,减少医疗费用。自1997年丹麦外科医师Kehlet提出ERAS以来,ERAS已在骨科、乳腺外科、心胸外科、胃肠外科、妇产科等多个外科领域开展[2-4]。目前,国际上已相继发布了择期结直肠手术、直肠和(或)盆腔手术、胰十二指肠手术和胃切除手术的ERAS指南或专家共识[5-8]。肝胆胰手术较复杂、创伤大,术后并发症发生率高,近年提倡并应用的精准、微创、损伤控制的现代外科理念为ERAS的施行奠定了基础[9]。目前,多家医疗中心开始在肝胆胰手术患者中施行ERAS,并取得了一定成效[10]。但如今,国内外均无一致的针对肝胆胰手术的ERAS方案来指导临床实践。因此,《中华消化外科杂志》编辑委员会和中国研究型医院学会肝胆胰外科专业委员会组织业内专家,启动了《肝胆胰外科术后加速康复专家共识(2015版)》(以下简称本共识)讨论会,总结国内外该领域研究进展及专家经验,按照循证医学原则,通过深入论证,最终制订本共识,旨在为实现我国肝胆胰外科手术ERAS的规范化、标准化提供参考意见。
参考文献
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