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浙江大学学报（医学版）
浙江大学学报（医学版）  2017, Vol. 46 Issue (6): 675-678    DOI: 10.3785/j.issn.1008-9292.2017.12.16
综述     
康复医学在加速康复外科中的应用
李海军(),陈作兵*()
浙江大学医学院附属第一医院康复医学科, 浙江 杭州 310003
Application of rehabilitation medicine in enhanced recovery after surgery
LI Haijun(),CHEN Zuobing*()
Department of Rehabilitation, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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摘要：

加速康复外科已广泛应用于围手术期的优化处理。康复医学作为加速康复外科的重要组成部分，主要体现在对围手术期患者的体能管理、呼吸功能训练和运动训练等方面，可以降低术后肺部感染的发生、改善胃肠功能和提高心肺功能水平等。本文针对围手术期患者呼吸系统、肌肉骨骼系统、心血管系统、消化系统等方面的康复管理进行了详细阐述。
关键词： 康复/方法;  围手术期医护;  治疗应用    
Abstract:

Enhanced recovery after surgery (ERAS) has been widely used in perioperative optimization. As an important component of ERAS, rehabilitation medicine mainly focuses on perioperative physical fitness management, respiratory training, exercise training to reduce the incidence of postoperative pulmonary infection, improve gastrointestinal and cardiopulmonary function. This paper explains rehabilitation medicine for respiratory, musculoskeletal, cardiovascular and digestive systems during the perioperative period.
Key words: Rehabilitation/methods    Perioperative care    Therapeutic uses
收稿日期: 2017-05-12 出版日期: 2017-12-25
CLC:  R49  
基金资助: 浙江省中医药科技计划(2017ZK1003)
通讯作者: 陈作兵     E-mail: 15958018515@163.com;13957116610@163.com
作者简介: 李海军(1989-), 男, 硕士研究生, 初级治疗师, 主要从事外科术后康复的物理治疗、心肺康复; E-mail:15958018515@163.com; https://orcid.org/0000-0001-6852-2719
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引用本文:

李海军,陈作兵. 康复医学在加速康复外科中的应用[J]. 浙江大学学报（医学版）, 2017, 46(6): 675-678.

LI Haijun,CHEN Zuobing. Application of rehabilitation medicine in enhanced recovery after surgery. J Zhejiang Univ (Med Sci), 2017, 46(6): 675-678.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2017.12.16    或    http://www.zjujournals.com/med/CN/Y2017/V46/I6/675

1 SCOTT M J , BALDINI G , FEARON K C et al. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1:pathophysiological considerations[J]. Acta Anaesthesiol Scand, 2015, 59 (10): 1212- 1231
doi: 10.1111/aas.12601
2 鲍珊, 苏建华, 廖虎 et al. 肺癌合并慢性阻塞性肺病和手术方式对患者术后快速康复及治疗费用的影响[J]. 中国胸心血管外科临床杂志, 2014, 2 (1): 17- 20
BAO Shan , SU Jianhua , LIAO Hu et al. Impact of chronic obstructive pulmonary disease and surgical approach on postoperative fast track recovery and hospitalization cost of patients undergoing lung cancer resection[J]. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 2 (1): 17- 20
doi: 10.7507/1007-4848.20140006
3 LANGERON O , CARREIRA S , LE S F et al. Postoperative pulmonary complications updating[J]. Ann Fr Anesth Reanim, 2014, 33 (7-8): 480- 483
doi: 10.1016/j.annfar.2014.07.741
4 GAO K , YU P M , SU J H et al. Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery:A study for 342 cases[J]. Thorac Cancer, 2015, 6 (4): 443- 449
doi: 10.1111/tca.2015.6.issue-4
5 CHANG A T , BOOTS R J , HENDERSON R et al. Case report:inspiratory muscle training in chronic critically ill patients-a report of two cases[J]. Physiother Res Int, 2005, 10 (4): 222- 226
doi: 10.1002/(ISSN)1471-2865
6 TZANI P , CHETTA A , OLIVIERI D . Patient assessment and prevention of pulmonary side-effects in surgery[J]. Curr Opin Anaesthesiol, 2011, 24 (1): 2- 7
doi: 10.1097/ACO.0b013e328341abb3
7 KAYAMBU G , BOOTS R , PARATZ J . Physical therapy for the critically ill in the ICU:a systematic review and meta-analysis[J]. Crit Care Med, 2013, 41 (6): 1543- 1554
doi: 10.1097/CCM.0b013e31827ca637
8 CHEN Y H , LIN H L , HSIAO H F et al. Effects of exercise training on pulmonary mechanics and functional status in patients with prolonged mechanical ventilation[J]. Respir Care, 2012, 57 (5): 727- 734
doi: 10.4187/respcare.01341
9 JONES C , EDDLESTON J , MCCAIRN A et al. Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement:A randomized controlled trial[J]. J Crit Care, 2015, 30 (5): 901- 907
doi: 10.1016/j.jcrc.2015.05.002
10 SCHWEICKERT W D , POHLMAN M C , POHLMAN A S et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients:a randomised controlled trial[J]. Lancet, 2009, 373 (9678): 1874- 1882
doi: 10.1016/S0140-6736(09)60658-9
11 中国加速康复外科专家组 . 中国加速康复外科围手术期管理专家共识(2016)[J]. 中华外科杂志, 2016, 54 (6): 413- 418
Chinese Expert Group for Enhanced Recovery after Surgery . Chinese expert consensus on enhanced recovery after surgery in perioperative management (2016 edition)[J]. Chinese Journal of Surgery, 2016, 54 (6): 413- 418
12 VLUG M S , WIND J , HOLLMANN M W et al. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery:a randomized clinical trial (LAFA-study)[J]. Ann Surg, 2011, 254 (6): 868- 875
doi: 10.1097/SLA.0b013e31821fd1ce
13 HAINES K J , SKINNER E H , BERNEY S . Association of postoperative pulmonary complications with delayed mobilisation following major abdominal surgery:an observational cohort study[J]. Physiotherapy, 2013, 99 (2): 119- 125
doi: 10.1016/j.physio.2012.05.013
14 SOSNOWSKI K , LIN F , MITCHELLM L et al. Early rehabilitation in the intensive care unit:an integrative literature review[J]. Aust Crit Care, 2015, 28 (4): 216- 225
doi: 10.1016/j.aucc.2015.05.002
15 王慧敏, 樊志敏 . 针灸促进快速康复外科腹部术后胃肠功能恢复的探讨[J]. 中国中医急症, 2010, 19 (12): 2108- 2109
WANG Huimin , FAN Zhimin . Discussion of acupuncture and moxibustion promoting the recovery of gastrointestinal function after rapid rehabilitation of abdominal surgery[J]. Journal of Emergency in Traditional Chinese Medicine, 2010, 19 (12): 2108- 2109
doi: 10.3969/j.issn.1004-745X.2010.12.049
16 周细秋 . 快速康复理念在中西医结合结直肠外科领域中应用进展[J]. 上海中医药大学学报, 2014, (1): 91- 94
ZHOU Xiqiu . Application of fast-track idea in colorectal surgery combined with Chinese and western medicine[J]. Journal of Shanghai University of Traditional Chinese Medicine, 2014, (1): 91- 94
17 HAMBURG N M , MCMACKIN C J , HUANG A L et al. Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers[J]. Arterioscler Thromb Vasc Biol, 2007, 27 (12): 2650- 2656
doi: 10.1161/ATVBAHA.107.153288
18 PERHONEN M A , FRANCO F , LANE L D et al. Cardiac atrophy after bed rest and spaceflight[J]. J Appl Physiol(1985), 2001, 91 (2): 645- 653
doi: 10.1152/jappl.2001.91.2.645
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