基于ERAS的腹壁下深血管穿支皮瓣乳房重建术麻醉管理进展  

Progress in ERAS-based anesthetic management for patients undergoing deep inferior epigastric perforator flap breast reconstruction

作　　者：楼菲菲 张军 吴炅[2,3] LOU Fei-fei;ZHANG Jun;WU Jiong(Department of Anesthesiology,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Department of Breast Surgery,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院麻醉科,上海200032 [2]复旦大学上海医学院肿瘤学系,上海200032 [3]旦大学附属肿瘤医院乳腺外科,上海200032

出　　处：《复旦学报（医学版）》2024年第1期102-108,共7页Fudan University Journal of Medical Sciences

基　　金：上海市科委“科技创新行动计划”医学创新研究专项(20Y11906200)。

摘　　要：目前,手术后快速康复(enhanced recovery after surgery,ERAS)策略在腹壁下深血管穿支(deep inferior epigastric perforator,DIEP)皮瓣乳房重建术中的开展在全球尚处于起步和探索阶段,缺乏共识性的指导原则。在涉及多学科的ERAS策略中,麻醉科承担了麻醉方案优化制订、围术期液体管理及内环境稳态调控、预防低体温、完善围术期镇痛、预防术后恶心呕吐等要素工作。本文将复旦大学附属肿瘤医院麻醉科在DIEP皮瓣乳房重建术的ERAS策略中的麻醉方案进行归纳、总结,并结合国内外最新研究进展进行综述,以期建立和完善基于ERAS的该类手术的围术期策略。At present,the development of enhanced recovery after surgery(ERAS)pathways in deep inferior epigastric perforator(DIEP)flap breast reconstruction is still in the initial stage worldwide,lacking established guidelines.In the multidisciplinary ERAS pathways,the department of anesthesiology is responsible for some core elements such as optimizing anestheticprotocols,perioperative fluid management and homeostasis regulation,prevention of hypothermia,improvement of perioperative analgesia,and postoperative nausea and vomiting prophylaxis.We summarized the anesthetic management in the ERAS pathways for patients undergoing DIEP flap breast reconstruction in Fudan University Shanghai Cancer Center,along with the recent progress,aiming to establish and improve the perioperative strategy based on ERAS pathways in DIEP flap breast reconstruction.

关 键 词：手术后快速康复(ERAS) 腹壁下深血管穿支(DIEP) 皮瓣乳房重建术 麻醉方案 围术期管理 内环境稳态调控 

分 类 号：R614[医药卫生—麻醉学] R655.8[医药卫生—外科学]