切换至 "中华医学电子期刊资源库"

中华老年骨科与康复电子杂志 ›› 2023, Vol. 09 ›› Issue (06) : 321 -332. doi: 10.3877/cma.j.issn.2096-0263.2023.06.001

专家共识

中国髋、膝关节置换日间手术围手术期管理专家共识
中华医学会骨科分会关节学组   
  • 收稿日期:2023-10-09 出版日期:2023-12-05
  • 基金资助:
    国家自然科学基金面上项目(81672235)

Expert consensus on perioperative management of day surgery for hip and knee arthroplasty in China

  • Received:2023-10-09 Published:2023-12-05
引用本文:

中华医学会骨科分会关节学组. 中国髋、膝关节置换日间手术围手术期管理专家共识[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 321-332.

日间手术是指患者24 h内完成入、出院的手术或操作。因病情需要延期住院的特殊病例,住院时间不超过48 h。日间手术的开展有利于缩短住院时间,降低治疗费用,提高治疗质量,提升患者满意度,同时帮助医院合理支配医疗资源,提高医疗资源有效使用率。随着手术技术、麻醉技术及加速康复外科(ERAS)手段的发展,中国已经具备了开展髋、膝关节置换日间手术的条件。通过查阅文献,总结成功经验,遵循循证医学原则,经过全国专家反复讨论、修订、整理形成本共识,供广大骨科医生在临床工作中参考应用。本共识包括四部分内容:日间手术开展模式和团队建设、门诊初筛、围手术期管理、出院后随访和日间手术质量评估。

Day Surgery, also known as Ambulatory surgery, refers to surgical procedures in which patients are admitted and discharged within 24 hours. In special cases where hospitalization is required, the stay should not exceed 48 hours. The implementation of day surgery offers several advantages, including shorter hospital stays, reduced treatment costs, improved treatment quality, enhanced patient satisfaction, and more efficient allocation of medical resources by hospitals. With the development of surgical techniques, anesthetic technique, and Enhanced Recovery After Surgery (ERAS) protocols, China is now equipped to perform hip and knee joint arthroplasty as day surgeries. This consensus has been formed by reviewing the literature, summarizing successful experiences, following evidence-based medicine principles, and undergoing extensive discussions, editing, and organization by national experts. It is intended to serve as a reference for orthopedic surgeons in their clinical practice. This consensus comprises four main sections: the day surgery implementation model, team building, outpatient screening, perioperative management, post-discharge follow-up, and day surgery quality assessment.

表1 本指南中的证据质量分级与定义
表2 本指南中的推荐强度分级与定义
表3 中国髋、膝关节置换日间手术患者筛选标准
表4 中国髋、膝关节置换日间手术患者出院标准
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