手术后增强康复 (ERAS) 在最小侵入性妇科手术中的实践:一项全国调查
Azra Shivji1, Elizabeth Miazga2, Carmen McCaffrey3
1Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON; Department of Obstetrics and Gynecology, University of Toronto, Unity Health St. Michael's Hospital, Toronto, ON.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
|September 11, 2024
概括
手术后增强恢复 (ERAS) 途径改善了妇科手术中的患者结果. 加拿大坚持是多样化的,一些组件高度采用,但缺口仍然在关键领域,如手术前禁食.
科学领域:
- 最少侵入性的妇科手术.
- 手术成果研究的研究结果.
- 基于证据的医学是基于证据的医学.
背景情况:
- 手术后增强恢复 (ERAS) 途径是基于证据的协议,旨在最大限度地减少外科手术期间的压力.
- 埃拉斯旨在减少术后并发症和缩短康复时间.
- 在加拿大妇科手术中应用ERAS需要评估.
研究的目的:
- 评估加拿大最小侵入性妇科手术中ERAS建议的应用和遵守.
- 确定影响ERAS实施和普及的障碍.
- 为了比较拥有和没有建立ERAS计划的中心之间的坚持.
主要方法:
- 一项横截面调查分发给了加拿大158名产科和妇科专业人员.
- 该调查评估了根据美国妇科拉皮眼科医生协会 (ERAS) 指导方针对14个外科手术期间组件的遵守情况.
- 为了进行比较分析,受访者被分为具有或没有建立ERAS计划的组.
主要成果:
- 41.9%的受访者在有ERAS计划的中心工作.
- 在患者参与,设备更换,导管切除和早期动员方面观察到高坚持.
- ERAS编程改善了对碳水化合物负载,流体管理,正常热量和肠道方案的坚持 (P <0.05),但手术前禁食和并发症优化仍然很低.
结论:
- 加拿大从业人员使用各种ERAS组件,尽管正式的途径实施因地区而异.
- 埃拉斯项目地点对某些建议的遵守率更高,但在高证据组成部分仍然存在国家差距.
- 需要进一步的研究来解决障碍,并优化遵守低合规的ERAS建议,以改善外科护理.
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