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行食管癌根治术成年患者加速康复外科实施方案最佳证据总结

Summary of the best evidence for surgical implementation of accelerated rehabilitation programme in adult patients undergoing radical oesophageal cancer surgery
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摘要 目的提取并汇总国内外行食管癌根治术成年患者加速康复外科(ERAS)实施方案的相关证据。方法检索国内外指南网站、专业学会网站、中英文数据库中关于行食管癌根治手术的成年患者ERAS实施方案的文献,检索时限为从建库至2024年3月1日。对文献进行质量评价,对符合质量标准的文献进行证据提取。结果检索得到相关文献25篇,包括指南2篇、证据总结1篇、专家共识3篇、系统评价7篇、随机对照试验12篇;经筛选得到最佳证据18条,涉及术前、术中、术后、围术期成人ERAS实施方案。结论ERAS实施方案对行食管癌根治术成年患者的术后快速康复起到重要作用,18条最佳证据中术前全面评估、术中液体管理、术后早期营养支持证据推荐级别较高,医护人员可结合临床情境及患者意愿应用。 Objective To extract and summarise national and international evidence on surgical implementa-tion of enhanced recovery after surgery(ERAS)programmes for adult patients undergoing radical oesoph-ageal cancer surgery.Methods The literature on the implementation plan of enhanced recovery after sur-gery for adult patients undergoing radical resection of esophageal cancer was retrieved in guideline web-sites,professional society websites and Chinese and English databases at home and abroad.The search time limit was from the establishment of the database to March 1,2024.The quality of the literature was evaluated,and evidence was extracted from the literature that met the quality standards.Results 25 rele-vant literatures were retrieved,including 2 guidelines,1 evidence summary,3 expert consensus,7 sys-tematic reviews and 12 randomized controlled trials.After screening,18 best evidences were obtained,which involved the implementation plan of rapid rehabilitation surgery for adults before,during,after and perioperative period.Conclusion A full-process surgical implementation plan for accelerated rehabilitation plays an important role in the rapid postoperative recovery of adult patients undergoing radical esophageal cancer surgery,this study was summarized to form the 18 best pieces of evidence,in which preoperative comprehensive assessment,intraoperative fluid management,and early postoperative nutritional support have a high level of recommendation,and it is recommended that healthcare professionals apply the evi-dence in conjunction with the clinical situation and the patient's wishes.
作者 李帅 王丹 邵英梅 盛超 安佳叶 林素兰 LI Shuai;WANG Dan;SHAO Yingmei;SHENG Chao;AN Jiaye;LIN Sulan(State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,Urumqi 830054,China;School of Nursing,Urumqi 830017,China;Department of Hepatobiliary and Hydatid Diseases,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Health Care Research Center for Xinjiang Regional population,Urumqi 830017,China)
出处 《新疆医科大学学报》 CAS 2024年第11期1545-1552,共8页 Journal of Xinjiang Medical University
基金 省部共建中亚高发病成因与防治国家重点实验室资助项目(SKL-HIDCA-2023-HL11)。
关键词 食管癌 加速康复外科 循证护理学 esophageal cancer enhanced recovery after surgery evidence-based nursing
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