围术期处理的百年发展史:从应激到ERAS理念的提出  

The centennial history of perioperative management

作　　者：王若晨 杨笑[2] Wang Ruochen;Yang Xiao(Graduate school,Ningxia Medical University,Yinchuan 750004,China;Department of Neurology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学研究生学院,银川750004 [2]宁夏医科大学总医院神经内科,银川750004

出　　处：《中华医史杂志》2023年第6期371-375,共5页Chinese Journal of Medical History

基　　金：宁夏回族自治区重点研发计划(2018BFG02007)。

摘　　要：应激是个体面临环境变化时做出的全身适应性反应,是维持个体生存所必需的基本条件。1859年,达尔文阐述了外部环境对生命的影响;1878年,伯纳德提出稳定的内部环境是生命独立存在的首要条件;1914年坎农提出“应激”概念;1932年,卡斯伯特森证实手术应激会对患者产生巨大影响;2001年,克勒特提出加速康复外科(ERAS)概念,通过基于循证医学证据的一系列围手术期优化处理措施,减少手术创伤及应激,加速患者术后康复。随后,ERAS理念被迅速接受,成为引领21世纪现代外科技术进步的重要发展方向之一。Stress reaction is a systemic adaptive response of individual in face of changes in their environment.In 1859,Darwin elaborated on the influence of external circumstances on life.In 1878,Bernard hold that a stable internal environment is the primary condition for the independent existence of life.In 1914,Cannon proposed the concept of"stress reaction".In 1932,Casbertson confirmed that surgical stress can have a huge impact on patients.In 2001,Klerter introduced the concept of Enhanced Recovery Surgery(ERAS),which reduces surgical trauma and stress and accelerates postoperative recovery through a series of perioperative optimization measures based on evidence-based medical evidence.Subsequently,the concept of ERAS was quickly accepted and became one of the most important development directions leading the progress of modern surgical technology in the 21st century.

关 键 词：围手术期处理 发展历史 应激 加速康复外科 

分 类 号：R496[医药卫生—康复医学]