华西医学

华西医学

加速康复外科之围手术期肺康复的临床价值

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加速康复外科临床应用的良好效果体现在降低围手术期并发症的发生率并缩短住院时间,但不同的病种和手术方式在运用加速康复外科理念时都有其关键技术和策略。加速肺康复的关键技术是微创手术,且已得到普遍应用;主要策略是对合并高危因素的肺癌患者围手术期的肺康复训练与系统管理,其核心是肺康复训练,但肺康复训练的临床方案却不成熟。该文主要就术前肺康复训练方案的最佳适用人群、可操作的肺康复方案及其临床应用价值进行综述。

The great clinical efficacy of an enhanced recovery after surgery (ERAS) program has been illustrated by the decreased incidence of perioperative complications and the shortened length of in-hospital stay. Furthermore, the ERAS programs have their own key techniques and strategies in the clinical application to the unique diseases and operative modes. The key technology of an ERAS program is the minimally invasive surgery, which has been widely utilized in the surgical specialties. The main strategy in an ERAS program consists of the intensive pulmonary rehabilitation and optimal perioperative care that aim to improve the in-hospital outcomes of lung cancer patients who are considered at high surgical risk. Pulmonary rehabilitation is regarded as the mainstay of the ERAS strategies but its clinical protocols still remain less mature. The purpose of this overview is to summarize the current pulmonary rehabilitation programs in terms of the suitable crowd, the feasible protocols and the clinical significance.

关键词: 加速康复外科; 肺康复; 围手术期; 肺肿瘤