摘要
目的分析加速康复外科(ERAS)在国内外应用的评价指标研究现状,并对构建ERAS系统化评价模型提出思考与建议。方法检索Medline、Embase、Sciencedirect、ACP Journal Club、BioMed Central、the Cochrane Central Register of Controlled Trials(CENTRAL)、Science Citation Index Expanded、Cochrane Library、NHS Economic Evaluation Database、CNKI、VIP、万方等中英文数据库(检索时间均为1997年1月至2017年12月)。对文献进行筛选,剔除重复文献,最终纳入1 020篇英文文献和786篇中文文献进行分析总结。结果文献资料显示,目前国内外关于ERAS没有全面和系统的评价指标体系,现有的评价指标主要存在以下不足:(1)评价指标局域化、碎片化;(2)缺乏ERAS组织框架及过程管理的评价指标;(3)评价指标缺乏标准化操作性定义。结论国内外对ERAS管理模式的评价指标没有按照科学原理构成系统的评价指标体系,这将制约ERAS模式在我国的标准化推广。建立以医院、患者、社会及医疗管理机构多方评估为基础,涵盖ERAS组织构架,过程管理及临床结局的多维度综合的质量评价指标体系,这是ERAS未来发展的必需条件,也是当下亟待解决的重要问题。
Objective To analyze the progress of evaluation indexes for enhanced recovery after surgery （ERAS） model at home and abroad, and to propose suggestions for constructing systematic evaluation model of ERAS. Methods At first checked the Chinese and English databases, including Medline, Embase, Sciencedirect, ACP Journal Club, BioMed Central, the Cochrane Central Register of Controlled Trials （CENTRAL）, Science Citation Index Expanded, Cochrane Library, NHS Economic Evaluation Database, CNKI, VIP, and Wanfang databases （retrieval time was from January 1997 to December 2017）, and then filtered the literatures, excluded duplicate documents, a total of 1 020 English literatures and 786 Chinese literatures were enrolled eventually to make an review. Results The literatures showed that, at present, there was no comprehensive and systematic evaluation index system about ERAS at home and abroad. The existing evaluation indexes mainly included the following deficiencies： localization and fragmentation of evaluation indicators, lack of evaluation indicators of ERAS organizational framework and process management, as well as lack of standardized operational definition of evaluation indicators. Conclusions The evaluation indexes of ERAS at home and abroad do not constitute a systematic evaluation index system according to scientific principles, which will restrict the standardization of accelerated surgical rehabilitation in our country. To establish a multidimensional and comprehensive quality evaluation index system based on multi-evaluation of hospital, patient, social, and medical management institutions, which covers ERAS organizational structure, process management, and clinical outcomes, is a necessary condition for the development of ERAS model.
作者
李卡
杨婕
胡艳杰
刘雨薇
徐裕杰
冯金华
LI Ka;YANG Jie;HU Yanjie;LIU Yuwei;XU Yujie;FENG Jinhua(Nursing Department, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;West China College of Nursing, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;Department of Biliary Surgery, West China Hospital of Sichuan University. Chenedu 610041. P R China)
出处
《中国普外基础与临床杂志》
CAS
2018年第5期629-634,共6页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省科技厅支撑项目(项目编号:2013SZ0026)
关键词
加速康复外科
评价指标
研究进展
综述
enhanced recovery after surgery
evaluation indicator
research progress
review
