围手术期加速康复外科联合数字化监测创伤应激反应的应用及其前景  

Digitalization of perioperative traumatic stress in enhanced recovery after surgery program:current application and future prospect

作　　者：程伟 江志伟 Wei Cheng;Zhiwei Jiang(Department of General Surgery,Jiangsu Province Hospital of Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院南京中医药大学附属医院普通外科,南京210029

出　　处：《中华胃肠外科杂志》2022年第7期575-581,共7页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金(82100533);江苏省中医药局科技项目(JD201807);江苏省中医院高峰学术人才项目(y2021rc49);江苏省双创博士课题。

摘　　要：围手术期创伤应激是由麻醉、手术、疼痛、焦虑等刺激导致的一种全身性非特异性反应,贯穿整个围手术期,持续而过度的应激反应不利于患者术后康复。加速康复外科(ERAS)是现代外科的研究热点,ERAS可显著降低围手术期疼痛和应激,促进患者康复。但既往ERAS的研究中,通过皮质醇、炎性指标等参数对围手术期应激的评估既低效又不够客观准确。随着人工智能和信息技术的进步,可穿戴、无创、实时动态的心率变异度(HRV)监测可高效实现应激的数字化,且价格低,值得临床推广利用。HRV数字化监测围手术期应激与ERAS的联合运用研究已经显示出优势,未来的临床运用前景值得期待。Perioperative traumatic stress is a systemic nonspecific response caused by stimuli such as anesthesia,surgery,pain and anxiety,which lasts throughout the perioperative period.The continuous excessive stress response is not conducive to the postoperative rehabilitation of patients.Enhanced recovery after surgery(ERAS),a research hotspot of modern surgery,can significantly reduce perioperative pain and stress,thus promoting the rehabilitation of patients.With the progress of artificial intelligence and information technology,wearable,non-invasive,real-time heart rate variability(HRV)dynamic monitoring can effectively realize the digitalization of stress monitoring with low price,which is worthy of clinical application.Therefore,the use of HRV for digital monitoring of perioperative stress has a significant research value.Moreover,the combination of HRV and ERAS has shown its advantages and the prospect of clinical application is worthy of anticipating.

关 键 词：创伤应激反应 加速康复外科 心率变异度 数字化 

分 类 号：R473.6[医药卫生—护理学]