加速康复外科理念在妇产科临床的应用及展望

丹麦外科医生Kehlet对围手术期处理措施综合优化，于1997年首次提出加速康复外科（enhanced recovery after surgery，ERAS）理念，近年来该理念在欧美国家被广泛推广，并逐渐被国内采纳应用。ERAS从循证角度出发，力求降低对手术患者的生理及心理创伤应激反应，通过外科、麻醉、护理、营养等科室紧密合作，采取多种干预措施，对围手术期临床路径优化，降低围手术期创伤应激反应及减少术后并发症的发生率，促进康复，缩短住院时间，减少医疗费用。这一理论体系自1997年正式提出以来相继在各外科领域推广应用，目前ERAS理念已应用于胸外科、普外科、结直肠外科、妇产科等的围手术期。近年来ERAS理念与妇产科围手术期管理模式相融合的成功案例众多，就目前ERAS理念在妇产科临床的应用进行综述。

Application and Prospect of Enhanced Recovery after Surgery in Obstetrics and Gynecology

The Danish surgeon Kehlet comprehensively optimized the perioperative management measures. In 1997, he first proposed the concept of enhanced recovery after surgery(ERAS). In recent years, the concept has been widely promoted in Europe and the United States, and has gradually been adopted and applied domestically. From the perspective of evidence-based, ERAS strives to reduce the physiological and psychological traumatic stress response of surgical patients. Through the close cooperation of departments such as surgery, anesthesia, nursing, and nutrition, it takes a variety of interventions to optimize the perioperative clinical pathway, reduce perioperative traumatic stress response and the incidence of postoperative complications, promote rehabilitation, shorten hospital stay, and reduce medical expenses. This theoretical system has been promoted and applied in various surgical fields since it was officially put forward in 1997. At present, ERAS has been applied to the perioperative period of thoracic surgery, general surgery, colorectal surgery, obstetrics and gynecology. In recent years, there have been many successful cases in which ERAS and the perioperative management model of obstetrics and gynecology have been combined. The current application of the concept of surgery in the clinical practice of obstetrics and gynecology is reviewed.