加速康复外科在大范围肝切除围术期的临床实践  

The clinical practice of enhanced recovery after surgery in perioperative period of extensive hepatectomy

作　　者：钱建平[1] 朱碧娟 张起帆[1] 孙世波[1] 朱碧丽[2] 李加[2] 付霞[2] 张思云[1] 李欢娱 谭清 周杰[1] 王恺[1] QIAN Jian-ping;ZHU Bi-juan;ZHANG Qi-fan;SUN Shi-bo;ZHU Bi-li;LI Jia;FU Xia;ZHANG Si-yun;LI Huan-yu;TAN Qing;ZHOU Jie;WANG Kai(Division of Hepatobiliopancreatic Surgery,Department of General Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong,China;Huiqiao Medical Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong,China)

机构地区：[1]南方医科大学南方医院普通外科学肝胆胰外科,广东广州510515 [2]南方医科大学南方医院惠侨医疗中心,广东广州510515

出　　处：《加速康复外科杂志》2020年第2期85-91,共7页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

基　　金：国家自然科学基金项目(82070642,81803063);中央引导地方科技发展专项资金项目(KTP20190242);广东省自然科学基金面上项目(2020A1515011205);南方医院院长基金项目(2018C029)。

摘　　要：近年来,加速康复外科(enhanced recovery after surgery,ERAS)在肝脏外科领域的应用和研究越来越多,国内外也有相关共识发表。但大范围肝切除因手术方式和过程复杂,围术期并发症发生率较高,如何安全、有效地实施ERAS,仍然需要进一步研究探索。本文介绍了南方医科大学南方医院普通外科学肝胆胰外科在大范围肝切除病例中开展ERAS的临床实践经验,笔者认为对于大范围肝切除应实施精准外科理念下的ERAS,以提高其安全性、稳定性。The applications and researches of enhanced recovery after surgery(ERAS)in the field of liver surgery are increasing in recent years,and relevant consensuses have been published at home and abroad.However,due to the complexity of surgical methods and procedures of extensive hepatectomy,the incidence of perioperative complications is high.How to implement ERAS safely and effectively still needs further research.This article introduces our clinical practice experience of implementing ERAS in extensive hepatectomy.The author proposes that ERAS should be performed under the concept of precision surgery to improve its safety and stability for extensive hepatectomy.

关 键 词：大范围肝切除 加速康复外科 精准肝脏外科 

分 类 号：R493[医药卫生—康复医学] R657.3[医药卫生—临床医学]