ERAS理念指导下围术期液体治疗的研究进展

加速康复外科(ERAS)是指围术期通过基于循证医学证据的一系列多模式策略来促进患者快速康复的新型理念。围术期液体治疗是ERAS的重要组成部分,包括术前、术中及术后3个阶段,其目的旨在维持患者术前、术中、术后的循环血容量状态,保证循环稳定和组织的有效灌注,避免组织缺血、缺氧,同时可以减轻患者手术应激,维护内环境稳定,降低术后呼吸、循环系统等重要脏器的并发症,加速患者康复。关于围术期液体治疗一直存在争议,目标导向液体治疗是目前大家公认的一种方法。本文将对ERAS理念指导下围术期液体治疗的最新进展及其对术后转归的影响作一综述。

Research progress of perioperative fluid therapy on the guidance of ERAS

Enhanced recovery after surgery(ERAS)is a new concept of accelerating the recovery of patients through a series of multi-mode strategies based on evidence-based medicine date in perioperative period.The perioperative fluid therapy is an important part of ERAS,including three phases of preoperative、intraoperative and postoperative.Its aim is to maintain the circulation volume to ensure circulation stability and effective perfusion of tissues,to avoid tissue ischemia and hypoxia,and to reduce surgical stress,maintain internal environment stability,reduce postoperative respiratory and circulatory complications,thus accelerating recovery.Fluid therapy has been controversial,Goal-directed Fluid Therapy is a recognized method.This article reviews the latest advances in preoperative,intraoperative and postoperative fluid therapy on the guidance of ERAS and its influence on postoperative outcomes.