加速康复外科(ERAS)理念在国际上应用已有近20年,改变了我们长期以来习以为常的围手术期处理原则,加速了患者的术后康复,减轻了术后痛苦,节约了医疗资源,是现代医学进步的里程碑。ERAS在中国西部地区的应用虽然有一定的进步,但从整体实施的质量与推广的范围看都落后于国际水平,与我国ERAS开展较好的单位与地区相比,存在一定的差距,术后平均住院日显著长于国际通常的3~5 d。建议:(1)我国西部地区医疗机构应根据已发布的专家共识,以结直肠外科实施ERAS的成功经验为基础,利用示范基地,大力推广此项技术,并积极进行科普宣传,把ERAS适宜技术推广到广大基层医院,改变医务人员以及患者心中根深蒂固的传统观念;(2)相关行政部门应该把ERAS作为适宜的推广技术列入年度工作计划,甚至作为医院质量考评指标之一;(3)在医院层面,应该建立院级多学科团队,麻醉、外科、营养及护理部协同攻关,提高ERAS的实施质量。ERAS在我国西部地区的普及与标准化是必然的。相信未来会有更多的中国西部临床研究为ERAS增添新的内容,制定更符合中国国情以及更符合西部地区特色的共识。
Enhanced recovery after surgery (ERAS) has been widely used in the world for near 20 years, which should be considered as the milestone of modern medicine advancement, changing the routine perioperative principle, accelerating the recovery speed following operation, minimizing the postoperative pain, and saving the medical resources. Despite the remarkable advance, the quality and application of ERAS in the west China needs further improvement if compared with international level or even some domestic hospitals. The postoperative hospital stay in west China is much longer than the reported 3 to 5 days according to published references. Several suggestions can be help: (1) Based on the published consensus and the successful experiences of ERAS in colorectal surgery, the medical institution should make great effort to extend this technique to change the profound traditional idea in medical staffs and patients. (2) The medical administrations should take the application of ERAS as a key performance index and annual work plan in hospital. (3) Multiple disciplinary team including anesthetist, surgeon, dietitian, and nurses is essential for hospital to promote the quality of ERAS. Undoubtedly, ERAS is going to be the conventional medical care in the western area of China. We may look forward to seeing more researches from western China to update the ERAS consensus.