在内镜外科手术后改善康复:建立全面的协议,以改善外科手术期间的患者护理
Louis-Xavier Barrette1, William G Cohen1, Tiffany Chao1
1Department of Otorhinolaryngology-Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania USA.
World journal of otorhinolaryngology - head and neck surgery
|March 12, 2025
概括
对于内镜外科手术 (ESS) 的手术后增强恢复 (ERAS) 协议并不广泛使用. 本综述详细介绍了ESS ERAS协议,并评估了改善患者结果的关键干预措施的证据.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术创新 在外科创新.
- 基于证据的医学基于证据的医学.
背景情况:
- 手术后增强恢复 (ERAS) 协议在内镜鼻手术 (ESS) 中没有得到广泛应用.
- 缺乏对现有的ERAS建议和ESS支持文献的批判性审查.
- 本研究旨在通过介绍ESS特定的ERAS协议来弥补这一差距.
研究的目的:
- 描述一个全面的ERAS协议,为接受ESS的患者量身定制.
- 批判性地评估可用的科学证据,支持拟议ESS ERAS协议的每个组成部分.
- 为在ESS中实施基于证据的术后干预提供一个框架.
主要方法:
- 使用Medline (PubMed) 和Scopus对相关手术和麻醉领域的ERAS协议进行了系统的文献搜索.
- 关键词包括"内镜外科手术"",鼻手术"",FESS"和"ESS".
- 使用牛津证据医学中心的标准来评分证据质量,干预强度被评为"强"",弱"或"有条件".
主要成果:
- 强有力的建议包括患者教育,尽量减少手术前禁食,局部/局部麻醉,静脉内全麻醉,避免喉包装,术后鼻灌和多模式止痛.
- 有条件的建议支持抗生素预防.
- 较弱的建议适用于外科手术期间的静脉血栓栓塞预防,控制的低血压和鼻包装/敷料的使用.
结论:
- 可以使用基于证据的干预措施开发ESS的全面ERAS协议.
- 该协议的实施可能会提高手术结果和患者满意度.
- 这项研究为在ESS中采用标准化的ERAS途径提供了基础.
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