加速康复外科(enhanced recovery after surgery,ERAS)理念推动了日间手术的革新,更多复杂手术、四级手术得以采用日间手术模式进行.四川大学华西医院从2010年开始引入ERAS方案并逐步试行四级手术,通过合理准入、团队构建、优化治疗及护理程序,保证了日间手术的质量和安全.2019年1月-2023年8月,共2531例患者接受24h的早癌日间四级手术,延迟出院率2.09％,再就诊率2.57％,再入院率1.11％,无死亡患者,患者满意度在98％以上.日间四级手术围手术期管理方案可为日间手术病种扩大化后的管理提供参考.
West China experience in perioperative management of fourth-level day surgery based on enhanced recovery after surgery concept
As the concept of enhanced recovery after surgery(ERAS)has promoted the revolution of day surgery,more complicated surgery such as radical resection of early cancer and other fourth-level surgery can be performed in day surgery mode.Since 2010,West China Hospital of Sichuan University has introduced ERAS program and gradually performed fourth-level surgery in day surgery center.With the measures of reasonable inclusion criteria,team construction,and optimization of treatment and nursing procedures,the quality and safety of day surgery are guaranteed.Between January 2019 and August 2023,a total of 2 531 patients underwent 24-hour fourth-level day surgery for early cancer,with a delayed discharge rate of 2.09％,a readmission rate of 2.57％,and a readmission rate of 1.11％,without death case,and the patient satisfaction was above 98％.The perioperative management scheme of fourth-level day surgery provides a reference for the management of day surgery for more diseases.
Enhanced recovery after surgeryday surgeryfourth-level surgeryrehabilitation
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