在西班牙的胸部手术中实施增强恢复协议的标准化建议:德尔菲共识研究
Néstor J Martínez-Hernández1, Alberto Cabañero-Sánchez2, Juan Manuel Córcoles-Padilla3
1Department of Thoracic Surgery, Hospital Universitario La Ribera, Alzira, Spain; Department of Thoracic Surgery, Hospital Biomédico Ascires, Valencia, Spain; Universidad Europea de Valencia. Faculty of Biomedical and Health Sciences, València, Spain.
概括
这项研究开发了基于证据的肺癌手术术后增强恢复 (ERAS) 建议. 这些指南旨在改善患者的治疗结果,并规范胸部外科手术的护理.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
背景情况:
- 肺癌的肺切除手术具有显著的并发症风险,尽管有微创进步.
- 手术后增强恢复 (ERAS) 协议可以改善结果,但采用不一致.
- 在胸部外科手术中存在需要标准化,基于证据的ERAS建议.
研究的目的:
- 为胸部外科的ERAS策略制定基于证据的建议.
- 将多学科专家和患者的见解纳入ERAS协议开发中.
- 为了解决ERAS协议在肺癌手术中的不一致采用.
主要方法:
- 一个两轮的德尔菲共识过程,涉及胸部外科专家.
- 在术前,术后和术后阶段制定62条建议.
- 在利克特等级上,共识被定义为≥66%的同意或不同意.
主要成果:
- 在术前 (91.7%),术后 (86.7%) 和术后 (85%) 建议方面达到了高度共识.
- 关键建议包括预康复,多式阿片类药物节约性止痛,微创手术,早期排水和早期动员.
- 建立了一套全面的62个基于共识的建议,用于术后护理.
结论:
- 为胸部手术患者建立了一个结构化,基于共识的术后管理协议.
- 优化的术后护理和标准化的干预措施旨在改善临床结果并促进康复.
- 建议可以促进更广泛的ERAS采用,改善患者康复和资源利用.
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