ERAS理念在结直肠癌患者围术期的应用研究进展
Research Progress on the Application of ERAS Concept in the Perioperative Period of Colorectal Cancer Patients
DOI: 10.12677/acm.2025.1582354, PDF,   
作者: 孙梦云, 宋 雪*, 王 宁, 许美姿：延安大学延安医学院，陕西 延安
关键词: ERAS；结直肠癌；围术期；护理；ERAS； Colorectal Cancer； Perioperative； Nursing
摘要: 加速康复外科(ERAS)理念以循证医学为基础，通过多学科协作优化结直肠癌围术期管理，降低并发症并促进康复。本文综述了ERAS在结直肠癌围术期应用的最新进展，涵盖术前、术中和术后三个阶段的关键措施。研究表明，ERAS可有效降低结直肠癌并发症发生率、缩短住院时间并提高患者满意度。然而，我国ERAS的推广仍面临基层医院资源不足、多学科协作机制不完善及患者依从性差异等挑战。未来需进一步标准化路径、强化基层培训并优化患者教育，以全面提升ERAS的应用效果。
Abstract: The Enhanced Recovery After Surgery (ERAS) protocol, grounded in evidence-based medicine, optimizes perioperative management for colorectal cancer through multidisciplinary collaboration, reducing complications and promoting recovery. This review summarizes recent advances in ERAS applications during the perioperative period, focusing on key interventions across the preoperative, intraoperative, and postoperative phases. Studies demonstrate that ERAS effectively reduces complication rates, shortens hospital stays, and improves patient satisfaction in colorectal cancer. However, its widespread adoption in China faces challenges, including limited resources in primary hospitals, insufficient multidisciplinary coordination, and variability in patient compliance. Future efforts should prioritize standardizing ERAS pathways, enhancing training for grassroots medical institutions, and optimizing patient education to maximize the benefits of ERAS implementation.
文章引用：孙梦云, 宋雪, 王宁, 许美姿. ERAS理念在结直肠癌患者围术期的应用研究进展[J]. 临床医学进展, 2025, 15(8): 1208-1214. https://doi.org/10.12677/acm.2025.1582354

参考文献

[1] Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R.L., Soerjomataram, I., et al. (2024) Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 74, 229-263. [Google Scholar] [CrossRef] [PubMed]
[2] 杜凯微, 姜霞, 王园园, 等. 基于两种评分系统对结直肠癌根治术后并发症预测价值的研究[J]. 中国全科医学, 2022, 25(27): 3390-3394.
[3] 王莉, 梁冰, 杨慧. 基于循证的加速康复外科的集束化干预方案对结直肠癌根治术患者术后恢复及并发症的影响[J]. 癌症进展, 2021, 19(2): 207-210, 214.
[4] 曹晖, 陈亚进, 顾小萍, 等. 中国加速康复外科临床实践指南(2021版) [J]. 中国实用外科杂志, 2021, 41(9): 961-992.
[5] Molenaar, C.J.L., Minnella, E.M., Coca-Martinez, M., ten Cate, D.W.G., Regis, M., Awasthi, R., et al. (2023) Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial. JAMA Surgery, 158, Article No. 572. [Google Scholar] [CrossRef] [PubMed]
[6] Yang, F., Yuan, Y., Liu, W., Tang, C., He, F., Chen, D., et al. (2024) Effect of Prehabilitation Exercises on Postoperative Frailty in Patients Undergoing Laparoscopic Colorectal Cancer Surgery. Frontiers in Oncology, 14, Article ID: 1411353. [Google Scholar] [CrossRef] [PubMed]
[7] 秦珮珮, 金菊英, 闵苏, 等. 术前快速康复操对腹腔镜结直肠癌根治术后恢复的影响[J]. 临床麻醉学杂志, 2021, 37(2): 119-122.
[8] 王宁, 于冠宇, 张卫. 结直肠术前的肠道准备[J]. 中华胃肠外科杂志, 2024, 27(6): 642-645.
[9] 张锐, 叶向红, 王慧君, 等. 术前肠内营养对结直肠癌病人术后康复影响的Meta分析[J]. 肠外与肠内营养, 2021, 28(3): 171-177.
[10] 王刚, 陆峰, 周井荣, 等. 加速康复外科在结直肠癌患者中的应用价值[J]. 中国基层医药, 2020, 27(13): 1559-1563.
[11] 叶清妹, 吴荔, 林莉, 等. 快速康复护理在结直肠癌伴糖尿病患者围手术期中的应用效果[J]. 糖尿病新世界, 2020, 23(9): 108-109, 112.
[12] Anifalaje, O.K., Ojo, C., Balogun, O.T., et al. (2024) The Determinants of Long-Term Outcomes After Colorectal Cancer Surgery: A Literature Review. Cureus, 16, e74985.
[13] 兰文玉. 快速康复外科护理干预在结直肠癌围术期中的应用及对睡眠质量的影响[J]. 世界睡眠医学杂志, 2022, 9(12): 2417-2420.
[14] 许晶晶, 张晓平. 基于快速康复外科理念的早期康复护理干预对中老年结直肠癌术后恢复的影响[J]. 护理实践与研究, 2020, 17(2): 91-93.
[15] 李敏, 江志伟, 许睿, 等. 加速康复外科精准护理在结直肠癌围术期的应用及效果评价[J]. 四川大学学报(医学版), 2023, 54(4): 746-751.
[16] 林梅琼. ERAS理念下手术室护理加复合保温策略干预在腹腔镜下直肠癌手术患者中的应用效果观察[J]. 哈尔滨医药, 2025, 45(2): 142-144.
[17] 刘庆荣, 贾晋莉, 何小东. 基于ERAS理念的手术室护理在4K腹腔镜结肠癌根治术中的应用[J]. 护理实践与研究, 2023, 20(4): 613-616.
[18] 李晶, 赵宝成, 王振军. 加速康复外科理念下结直肠癌围手术期营养支持治疗[J]. 临床外科杂志, 2021, 29(7): 693-695.
[19] 邵卫玲, 赵雯, 王宏刚, 等. 加速康复外科在结直肠癌中的应用[J]. 临床与病理杂志, 2020, 40(3): 698-703.
[20] Sato, H., Ota, H., Munakata, K., Matsuura, Y., Fujii, M., Wada, N., et al. (2022) Perioperative Fluid Management Influences Complication Rates and Length of Hospital Stay in the Enhanced Recovery after Surgery (ERAS) Protocol for Patients with Colorectal Cancer. Surgery Today, 53, 242-251. [Google Scholar] [CrossRef] [PubMed]
[21] Mehdiratta, L., Mishra, S.K., Vinayagam, S. and Nair, A. (2021) Enhanced Recovery after Surgery (ERAS)…. Still a Distant Speck on the Horizon! Indian Journal of Anaesthesia, 65, 93-96. [Google Scholar] [CrossRef] [PubMed]
[22] Mancel, L., Van Loon, K. and Lopez, A.M. (2021) Role of Regional Anesthesia in Enhanced Recovery after Surgery (ERAS) Protocols. Current Opinion in Anaesthesiology, 34, 616-625. [Google Scholar] [CrossRef] [PubMed]
[23] 张敏, 张亚宁, 刘圆圆. 腹腔镜结直肠癌根治术患者围术期实施快速康复护理的效果分析[J]. 贵州医药, 2021, 45(8): 1311-1312.
[24] 林燕惠, 林艺如. 分析结直肠癌围术期快速康复护理对患者康复效果及睡眠质量影响[J]. 世界睡眠医学杂志, 2023, 10(10): 2415-2418.
[25] 魏小宁, 曾飞格, 卓小浪. 排气操联合快速康复护理对结直肠癌患者外科术后早期肠道功能恢复及并发症的影响[J]. 临床与病理杂志, 2023, 43(4): 803-809.
[26] 赵伟伟, 杨路路, 石亚然, 等. 医护一体化快速康复外科护理在结直肠癌手术病人中的应用[J]. 护理研究, 2023, 37(24): 4531-4534.
[27] 张晓玲, 罗衡桂, 陈伟, 等. 加速康复外科管理模式在老年结直肠癌围手术期应用效果[J]. 中国普通外科杂志, 2022, 31(1): 132-138.
[28] 贺婷, 左莹, 钟玉超. 时机理论下医护一体化延续性护理对结直肠癌术后造口患者康复效果的影响[J]. 检验医学与临床, 2023, 20(18): 2767-2772.
[29] 卢溪. 思维导图与快速康复护理理念在结直肠癌患者阶段性健康教育中的应用[J]. 长春中医药大学学报, 2021, 37(2): 433-435.
[30] 支梦伟, 戴新娟, 江志伟, 等. 不同时机穴位贴敷对腹腔镜下结直肠癌根治术后胃肠功能恢复及心率变异度的影响[J]. 中国针灸, 2020, 40(9): 947-952.
[31] 林昌伟, 陈顺楷, 胡桂, 等. 多穴位针刺治疗促进结直肠癌患者术后胃肠功能恢复的前瞻性随机对照研究[J]. 中国普通外科杂志, 2024, 33(9): 1507-1516.
[32] 余绪超, 徐晨, 邓思洋, 等. 扶脾益肠汤联合快速康复外科理念在结直肠癌患者中的应用研究[J]. 中华中医药学刊, 2023(12): 116-119.
[33] 赫兰晔, 陈楠, 李嘉俊, 等. 从医护人员的角度调查结直肠癌围手术期中西医结合干预措施的认知[J]. 世界科学技术-中医药现代化, 2021, 23(8): 2823-2829.
[34] Weets, V., Meillat, H., Saadoun, J.E., Dazza, M., de Chaisemartin, C. and Lelong, B. (2024) Impact of an Enhanced Recovery after Surgery (ERAS) Program on the Management of Complications after Laparoscopic or Robotic Colectomy for Cancer. Annals of Coloproctology, 40, 440-450. [Google Scholar] [CrossRef] [PubMed]
[35] Forster, C. and Gonzalez, M. (2022) Enhanced Recovery after Surgery (ERAS): Philosophy, Theory and Practice. Journal of Thoracic Disease, 14, 3684-3687. [Google Scholar] [CrossRef] [PubMed]

为你推荐