骨科、麻醉科加速康复围手术期患者血液管理专家共识(2025年版)  

Expert consensus on perioperative blood management in orthopaedics and anesthesiology for enhanced recovery after surgery(2025 version)

作　　者：中国康复技术转化及发展促进会 中华医学会麻醉学分会 中国医师协会麻醉学医师分会 中国研究型医院学会 缪长虹[2] 吴新宝 俞卫锋[4] 裴福兴 谢锦伟 廖刃 向兵 何金汗 郭向阳[6] 李军 朱建栋 牛挺 China Association of Rehabilitation Technology Transformation and Promotion;Chinese Medical Association of Anesthesiology;Chinese Medical Doctor Association of Anesthesiologist;Chinese Research Hospital Association;Miao Changhong;Wu Xinbao;Yu Weifeng;Pei Fuxing

机构地区：[1]不详 [2]复旦大学附属中山医院 [3]首都医科大学附属北京积水潭医院 [4]上海交通大学医学院附属仁济医院 [5]四川大学华西医院 [6]北京大学第三医院 [7]温州医科大学附属第二医院 [8]无锡市第九人民医院

出　　处：《中华骨科杂志》2025年第7期393-401,共9页Chinese Journal of Orthopaedics

摘　　要：围手术期患者血液管理是骨科手术加速康复成功实施的关键技术之一,其核心理念是通过一系列措施增加患者术前血液储备、降低出血风险、减少围手术期失血及提高贫血耐受性。虽然围手术期患者血液管理的临床获益显著,但对多学科之间的共性问题仍有待进一步达成共识。共识基于Delphi法的实践要求,对骨科医生、麻醉科医生共同关注的术前缺铁性贫血的诊断与治疗、术中微创操作、氨甲环酸的应用、控制性降压及术后贫血诊治等18个临床问题相关的循证医学证据与临床实践进行了系统总结并形成共识,旨在促进以患者为中心的骨科加速康复更好地实施。Perioperative blood management for patients is one of the key techniques for the successful implementation of enhanced recovery after orthopaedic surgery.Its core concept is to increase the preoperative blood reserve of patients,reduce the risk of bleeding,minimize perioperative blood loss,and improve anemia tolerance through a series of measures.Although the clinical benefits of perioperative patient blood management are significant,there is still a need to further reach consensus on the common issues among multiple disciplines.Based on the practice requirements of the Delphi method,the consensus systematically summarizes the evidence-based medical evidence and clinical practice related to 18 clinical questions,including the diagnosis and treatment of preoperative iron deficiency anemia,minimally invasive operation during surgery,the application of tranexamic acid,controlled hypotension,and the diagnosis and treatment of postoperative anemia,which are of common concern to orthopaedic surgeons and anesthesiologists.The consensus aims to promote the better implementation of patient-centered enhanced recovery after orthopaedic surgery.

关 键 词：术后加速康复 疾病管理 循证医学 共识 

分 类 号：R687[医药卫生—骨科学]