[结构化实施快速途径以促进选择性结直肠切除术后的康复:来自德国五家医院的初步结果]
Wolfgang Schwenk1,2, Sven Flemming3, Monsserat Girona-Johannkämper4
1Gesellschaft für Optimiertes perioperatives Management, GOPOM GmbH, Düsseldorf, Deutschland. schwenk@gopom.de.
Chirurgie (Heidelberg, Germany)
|November 10, 2023
概括
德国医院对快速手术 (手术后更好的康复) 的结构化实施,在结直肠手术后显著加速了患者的康复. 合规率超过75%,表明成功采用了增强的恢复协议.
科学领域:
- 在外科手术期间的医学.
- 外科手术的结果
- 医疗保健 实施 科学 科学
背景情况:
- 多模式优化外科手术周边管理 (手术后增强恢复,ERAS) 加快选择性结直肠切除的恢复.
- 快速手术方案尚未成为德国临床实践中的标准.
- 这项研究评估了德国五家医院的结构化快速实施方案.
研究的目的:
- 评估德国医院结构化快速实施的可行性和影响.
- 评估遵守快速通道要素,术后并发症,功能恢复和住院.
- 为了确定德国医疗保健环境中是否可以实现高坚持率.
主要方法:
- 未来13个月的数据收集 (3个月的准备时间,10个月的实施时间).
- 包括接受选择性结直肠切除的成年患者.
- 快速治疗前期 (pre-FAST) 和快速治疗 (FAST) 阶段之间的结果比较,分析坚持,并发症,康复和停留时间.
主要成果:
- 快速通道的遵守率显著增加,从52%增加到83% (p < 0.01).
- 快速治疗组的患者在关键康复里程碑和整体住院期间的持续时间明显缩短.
- 两组之间并发症,重新手术或再入院率没有显著差异.
结论:
- 结构化的实施使得德国医院能够实现高的快速通道合规率 (>75%).
- 快速通道协议可显著加速患者在选择性结直肠切除后的康复.
- 这些发现支持在德国更广泛地采用手术后增强恢复.
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