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退变性脊柱侧凸手术加速康复外科围手术期管理策略专家共识
白玉树1△,翟骁1△,陈自强1,魏显招1,杨明园1,杨操2,周许辉3,李危石4,李利5,吴继功6,许建中7,赵建华8,王达义9,钱邦平10,朱泽章10,胡勇11,孙武权12,房敏12,郑召民13,王征14,李淳德15,丁文元16,夏磊17,沈建雄18,仉建国18,孙天胜19,罗卓荆20,海涌21,吕国华22,郝定均23,邱勇10,李明1*
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(1. 海军军医大学(第二军医大学)长海医院骨科, 上海 200433;
2. 华中科技大学同济医学院协和医院骨科, 武汉 430022;
3. 海军军医大学(第二军医大学)长征医院骨科, 上海 200003;
4. 北京大学第三医院骨科, 北京 100191;
5. 解放军总医院第四医学中心骨科, 北京 100048;
6. 战略支援部队特色医学中心骨科, 北京 100101;
7. 陆军军医大学重庆西南医院骨科, 重庆 400038;
8. 陆军特色医学中心大坪医院脊柱外科, 重庆 400042;
9. 湖北医药学院附属太和医院脊柱外科, 十堰 442008;
10. 南京大学医学院附属鼓楼医院脊柱外科, 南京 210008;
11. 香港大学李嘉诚医学院矫形与创伤外科学系, 香港 999077;
12. 上海中医药大学附属岳阳中西医结合医院推拿科, 上海 200437;
13. 中山大学第一附属医院脊柱外科, 广州 510080;
14. 解放军总医院骨科, 北京 100853;
15. 北京大学第一医院骨科, 北京 100433;
16. 河北医科大学第三医院脊柱外科, 石家庄 050051;
17. 郑州大学第一附属医院骨科, 郑州 510370;
18. 中国医学科学院、北京协和医学院北京协和医院骨科, 北京 100730;
19. 解放军总医院第七医学中心骨科, 北京 100700;
20. 空军军医大学西京医院骨科, 西安 710032;
21. 首都医科大学附属北京朝阳医院骨科, 北京 100020;
22. 中南大学湘雅二医院脊柱外科, 长沙 410011;
23. 西安交通大学附属红会医院脊柱外科, 西安 710054;
△共同第一作者
*通信作者)
摘要:
退变性脊柱侧凸常见于老年患者，通常合并高血压病、冠心病、糖尿病和骨质疏松等基础疾病，手术风险高、并发症多。加速康复外科（ERAS）要求综合考量患者的年龄、症状、体征、身体状况和骨质量等因素，以制定个体化的手术方案和围手术期干预措施，这对改善患者预后和康复十分重要。经全国多位脊柱外科专家多次讨论，在循证医学证据支持下，针对退变性脊柱侧凸手术ERAS围手术期管理策略制定本共识意见，供临床工作参考和应用。
关键词:  退变性脊柱侧凸  外科学  加速康复外科  围手术期  专家共识
DOI：10.16781/j.0258-879x.2020.03.0233
投稿时间：2020-02-24修订日期：2020-03-01
基金项目:国家自然科学基金（81972035，81701199），重大疑难疾病中西医临床协作试点项目[ZY （2018-2020）-FWTX-2005].
Enhanced recovery after surgery for degenerative scoliosis: consensus on perioperative management strategy
BAI Yu-shu1△,ZHAI Xiao1△,CHEN Zi-qiang1,WEI Xian-zhao1,YANG Ming-yuan1,YANG Cao2,ZHOU Xu-hui3,LI Wei-shi4,LI Li5,WU Ji-gong6,XU Jian-zhong7,ZHAO Jian-hua8,WANG Da-yi9,QIAN Bang-ping10,ZHU Ze-zhang10,HU Yong11,SUN Wu-quan12,FANG Min12,ZHENG Zhao-min13,WANG Zheng14,LI Chun-de15,DING Wen-yuan16,XIA Lei17,SHEN Jian-xiong18,ZHANG Jian-guo18,SUN Tian-sheng19,LUO Zhuo-jing20,HAI Yong21,Lü Guo-hua22,HAO Ding-jun23,QIU Yong10,LI Ming1*
(1. Department of Orthopaedics, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, China;
3. Department of Orthopaedics, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China;
4. Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, China;
5. Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing 100048, China;
6. Department of Orthopaedics, Special Medical Center of Strategic Support Force, Beijing 100101, China;
7. Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing 400038, China;
8. Department of Spinal Surgery, Army Special Medical Center(Daping Hospital), Chongqing 400042, China;
9. Department of Spinal Surgery, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan 442008, Hubei, China;
10. Department of Spinal Surgery, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, Jiangsu, China;
11. Department of Orthopaedics and Traumatology, HKU Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong 999077, China;
12. Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China;
13. Department of Spinal Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong, China;
14. Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China;
15. Department of Orthopaedics, Peking University First Hospital, Beijing 100433, China;
16. Department of Spinal Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, China;
17. Department of Orthopaedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 510370, Henan, China;
18. Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
19. Department of Orthopaedics, Seventh Medical Center of PLA General Hospital, Beijing 100700, China;
20. Department of Orthopaedics, Xijing Hospital, Air Force Medical University, Xi'an 710032, Shaanxi, China;
21. Department of Orthopaedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China;
22. Department of Spinal Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China;
23. Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China;
△Co-first authors.
* Corresponding author)
Abstract:
Degenerative scoliosis is common in the elderly, and is usually accompanied with underlying diseases such as hypertension, coronary heart disease, diabetes, and osteoporosis, resulting in high risk of surgery and many complications. Enhanced recovery after surgery (ERAS) requires the surgical team to draw up individualized surgical plans and perioperative interventions considering comprehensive aspects, including age, symptoms, physical signs, physical condition, and bone quality, so as to improve the prognosis and rehabilitation of patients after surgery. This consensus on the perioperative management procedure of ERAS for degenerative scoliosis has been made by experts of Spinal Surgery Department based on evidence-based medicine, and it can be used for clinical reference and application.
Key words:  degenerative scoliosis  surgery  enhanced recovery after surgery  perioperative period  consensus

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