基于ERAS理念探讨中医综合疗法在骨伤科疾病围手术期中的应用  

Study on the Application of TCM Comprehensive Therapy in the Perioperative Period of Orthopedic Injuries Based on ERAS Concept

作　　者：贾汝栋 王瑞杰 张丽 JIA Rudong;WANG Rujie;ZHANG Li(Baiyin Integrated Traditional Chinese and Western Medicine Hospital,Baiyin,Gansu,China,730900;Gansu University of Chinese Medicine,Lanzhou,Gansu,China,730000)

机构地区：[1]白银市中西医结合医院,甘肃白银730900 [2]甘肃中医药大学,甘肃兰州730000

出　　处：《河南中医》2023年第9期1320-1326,共7页Henan Traditional Chinese Medicine

摘　　要：加速康复外科(Enhanced Recovery After Surgery,ERAS)理念已在骨科临床治疗中广泛应用,主要表现在手术、术前宣教、麻醉、护理、镇痛以及术后康复治疗等方面,三大关键措施为:充分止痛、促进肠蠕动恢复、早期活动。运用中医综合疗法促进围手术期及术后患者快速康复的方法包括:重视患者心理健康,把“情志疗法”贯穿于骨伤科疾病治疗的始终;把中医“治未病”思想与ERAS理念相结合,关注骨伤科围手术期、术后康复及疾病转归;围手术期“中医综合疗法”内外结合,有效干预骨伤科疾病围手术期疼痛,参与ERAS疼痛管理(术前疼痛管理,术中疼痛、麻醉管理,术后疼痛管理及下肢静脉血栓的预防);运用中医综合疗法调节胃肠功能,参与围手术期胃肠道及营养管理;术后基于ERAS与中医理论进行康复管理,合理应用中医综合疗法及早进行康复训练。基于ERAS理念及中医学理论,优化临床治疗方案,充分、合理应用中医综合疗法,走具有中医特色的中西医结合发展之路,是中医参与骨伤科疾病围手术期治疗的有效方法。The concept of enhanced recovery after surgery(ERAS)has been widely applied in orthopedic clinical treatment,mainly manifested in surgery,preoperative education,anesthesia,nursing,analgesia,and postoperative rehabilitation treatment,etc.The three key measures are as follows:sufficient pain relief,promoting intestinal peristalsis recovery,and early activity.The methods of using TCM comprehensive therapy to promote rapid recovery of perioperative and postoperative patients include the following:Valuing patients'mental health and integrating"emotional therapy"throughout the treatment of orthopedic injuries;Combining the TCM concept of"preventing diseases before occurrence"with the ERAS concept,paying attention to the perioperative period,postoperative rehabilitation,and disease outcomes in orthopedic trauma surgery;Perioperative"TCM comprehensive therapy"being integrated internally and externally to effectively intervene in perioperative pain of orthopedic injuries,and participating in ERAS pain management(preoperative pain management,intraoperative pain and anesthesia management,postoperative pain management and prevention of lower limb vein thrombosis);Utilizing the TCM comprehensive therapy to regulate gastrointestinal function and participate in perioperative gastrointestinal and nutritional management;Postoperative rehabilitation management being based on ERAS and TCM theory,and early rehabilitation training being carried out through the rational application of TCM comprehensive therapy.Therefore,the effective methods for TCM to participate in the perioperative treatment of orthopedic injuries include optimizing clinical treatment plans,fully and reasonably applying the TCM comprehensive therapy,and pursuing the development path of integrated traditional Chinese and Western medicine based on the ERAS concept and TCM theory.

关 键 词：加速康复外科 情志疗法 治未病 中医综合疗法 围手术期 

分 类 号：R274.9[医药卫生—中西医结合]