加速康复外科理念在儿童肝囊型棘球蚴病患者围手术期应用的研究进展

Research Progress on the Application of Enhanced Recovery after Surgery Concepts in the Perioperative Management of Pediatric Patients with Hepatic Cystic Echinococcosis

摘要: 加速康复外科(enhanced recovery after surgery, ERAS)是一系列基于循证医学的围手术期优化措施，旨在减轻患者生理和心理的创伤应激，减少并发症，缩短住院时间，促进快速康复。儿童肝囊型棘球蚴病是一种由细粒棘球绦虫幼虫引起的严重寄生虫病，手术治疗仍是其主要根治手段。然而，传统围手术期管理策略常导致儿童患者应激反应大、恢复慢、并发症多。本文旨在系统综述加速康复外科理念在儿童肝囊型包虫病围手术期应用的最新进展，从术前、术中、术后三个环节详细阐述其核心措施，包括术前健康教育、营养支持、精准麻醉与微创手术、精细化疼痛管理与早期活动等，并分析其应用价值与面临的挑战，以期为临床实践提供参考，改善患儿预后。

Abstract: Enhanced Recovery After Surgery (ERAS) comprises a series of evidence-based perioperative optimization measures designed to alleviate patients’ physiological and psychological traumatic stress, reduce complications, shorten hospital stays, and promote rapid recovery. Pediatric hepatic cystic echinococcosis is a severe parasitic disease caused by the larval stage of Echinococcus granulosus, for which surgical intervention remains the primary curative treatment. However, traditional perioperative management strategies often result in significant stress responses, slow recovery, and numerous complications in pediatric patients. This article aims to systematically review the latest advances in the application of the ERAS concept in the perioperative management of pediatric hepatic cystic echinococcosis. It elaborates on the core measures throughout the preoperative, intraoperative, and postoperative phases, including preoperative health education, nutritional support, precise anesthesia and minimally invasive surgery, refined pain management, and early mobilization. Furthermore, it analyzes the application value and challenges faced, intending to provide references for clinical practice and improve patient outcomes.