188比分

【科学头条】十年执着,ERAS人文医学巨变之路

日期: 2021-09-28 阅读: 来源:188比分 关键词:

qingchendeyangguangzhaojinlanzhoudaxuediyiyiyuanxiongwaikedebingfang,44suidehuangxianshengchiguomantouxifan,dabuliuxingchuanguozoulang,laidaolouxiahuayuan,shaileyigeduoxiaoshitaiyang,kanzheneixieyufamaomideshuyeyijixinkaidehuaduo,tadeshentihexinqingdougewaiqingsong。fanhuibingfang,shuwanyixiaopingyeti,taheqizishoushizhedongxi,zhunbeichuyuanfanhui250gongliwaidegansuminxianjiazhong。

sheiyekanbuchu,zheishiyige8tianqiangangzuowanshiguanaishoushudebingren,gengrangrenxiangbudaodeshi,zaishuhou,tazaiyihudepeitongxiazijizouhuilebingfang。

zheizaiguoqubukexiangxiangdeyimudeyiyubuduanjinbudewaikeshoushuweichuanghua,gengdeyiyujiasukangfuwaikelinian(jianchengeras)zailanzhoudaxuediyiyiyuanquanmiantuixing。

食道癌手术后,他走出手术室

jigeyueqian,huangxianshengchifanshimingxiangandaogengye,zaidangdiyiyuanjiuzhenhouzhuandaolanzhoudaxuediyiyiyuanxiongwaike。jingguoweijinghebinglizhenduan,tabuxinglihuanshiguanxiongzhongduanai。jingguozhoumideshuqianjianchahepinggu,5yue6rizhongwu,xiongwaike、mazuishoushuke、zhongliuzhongxindeyihujinxingleshuqianduoxuekehuizhen(multi-disciplinary treatment,jianchengmdt)。

胸外科常规术前MDT讨论

yaozhidaojibianshiquanbushoushujunzaiqiangjingxiacaozuo、bingqieyifeichangchengshudexiongwaike,shiguanaishoushuyeyinweishejijingbu(huxixitong)、xiongbu(huxi、xunhuanxitong)、fubu(xiaohuaxitong)sangebuwei,bojizhudongmai、xinzang、qiguan、xiaqiangjingmai、jizhu、xiongdaoguandengduogezuzhijiegouerbeichengweixiongwaikechuangmianzuida、nanduzuigao、fengxianzuidadedaxingshoushu,shiwaikesijishoushu。

188比分suiranxiongwaikecongqunianxiabanniankaishiyiyoushijilifeiaibingrenshuhouzouchushoushushi、santianchuyuandexianli,danshiguanaibingrenshenmeshihoukeyizouchushoushushi?haimeiyoujiandaoguoneileisibaodaodexiongwaikezhurenhanbiaohenxiangtupoyixia,weicitayizhizaixunzhaoheshidebingli。

huangxianshengnianlingjiaoqing、shentijichutiaojianhao,nengbunengchangshi?yishenghushimenjisiguangyi,tantaoquedingzuiyanjindeshoushu、mazuijikangfujihua。

188比分dacongyizhuyuan,shirenxiongwaikefuhushizhangchentingjiuhetongshimenyiqijiaohuangxianshengsuochunhuxi、youxiaoketanhexiqigongnengduanlian,yiqijinyibugaishanxinfeigongneng。

188比分shuqiantouyitian,zhudaoyisheng、keshifuzhurenmaminjiehezhuzhiyishiliulixin,xianghuangxianshengjijiashuxiangxijiangjieleshoushuguochengyijishuhouzhuyishixiang。“zheiyeshierashechuantongshoushubuyiyangdedifang,jiaqiangxuanjiao,rangbingrenmingmingbaibaizuoshoushu。”maminjieshuo。

188比分suoyoudezhunbeidouchaozheeraszheigemubiaonuli,zhidengneiyikedeqiji。

188比分5yue7rishangwu8dian,qizijianghuangxianshengsongdaoleshoushushimenkou。8dianban,mazuikefuzhurenyishiliuyongqianghezhushouyiqi,anmazuijihuaweihuangxianshengshishilejingzhunquanshenmazui(feigelijishu)。9dian,shoushuzhunshikaishi。maminjie、liulixinfenbietongguojingbu、xiongbu、fubuzhijing5haomidao3limidejigexiaokong,yongxiongfuqiangjingjinxingzhejingmiwubideshoushucaozuo。liuyongqiangdengzetongguoyouchuangxueliudonglixuejiance、mazuishendujiancedeng,quanchengdiaokonghuanzhexunhuan、huxi、neihuanjing、tiyewending,diaokongyingjifanying,baohuzhongyaoqiguangongneng。

weilejianqingshuhoutengtong,waikeshoushujieshuhou,waikeyishengjinxingleqiangjingzhishixialeijianshenjingzuzhi,mazuiyishengduihuanzhejinxinglechaoshengyindaoxiajing、xiong、fuduobuweiquyushenjingzuzhiweijichudeshuhouduomoshizhentong,yibaozhenghuanzheshuhoulianghaodezhentongxiaoguo。sangebanxiaoshi,shoushuwanmeiwancheng。

188比分shuhou20fenzhong,huangxianshengzaihuifushilisuxingleguolai。shengmingtizhengpingwen,xueqifenxidabiao,bachuqiguanchaguan,meiyourenhetengtonghebushi;guanchalebanxiaoshi,zuoqilaishileshi,meiyoutouyun;xiachuang,fuzhezouyizou,ziwoganjuetinghao,“zheishihou188比分 juedingzouchuqu”,liuyongqiangshuo。

黄先生术后在麻醉医生的陪同下走出病房

shoushushiwai,kandaozheiyimudeqizishanranleixia。shoushushili,weishixiangaonandugaofengxianshoushuyuhuanzheshuhouhuifudelianghaozhuangtai“lianggejiduan”xiangtongyierfuchujudanulideyihurenyuan,yezaixinzhongmomoxinwei。

heyiwangdashoushuhoubingrenshenshangdaimanleguanzibutong,huangxianshengshenshangjinyouchaoxixiongqiangyinliuguan、shuzhuyaowuyongpicczhiguan、yingyangguandengsangenguanzi。chentinghetongshijiangtajiehuibingfang,jiancegexiangshenglizhibiaozhengchanghoujiechulexindianjianhu,zaicizhufuleyouxiaoketan、shuhouduanlianjihuadengzhuyishixiang。

188比分huangxianshengmeixiangguo“shoushuhaikeyizheiyangzuo”,xingfendeyiwanshangmeishuihaojue。shuhoudiyitian,tayijingkeyizizhuxiadiraochuangzoulu;diertian,xishu、shangcesuo、xialousanbudengyibanshenghuojunkezili,tahaitongguobisi“he”daolechangneiyingyangye,tongshizhubukaishijingkouchifanheshui;dibatian,chuyuan。duiyulunliuzhaogutadeqizihedidilaishuoyeshigewaiqingsong,“jihubuyongguan”!

正在进行捏球训练以预防血栓、即将出院的黄先生

188比分hanbiaogankaidao: “congzaoqishidaoaishoushuxiongbu40limi、fubu20limi、jingbu7-8limiqiekou,dao2009nian188比分 zaiguoneidiyipikaizhanqiangjingshiguanshoushu,zaidaorujinxiongfuqiangjinglianhezhixuyaozhijingjihaomidaojilimideqibagexiaokong;congyuanlaimuzhicude36haoxiongqiangyinliuguan、bingrentengdaoyaosi,daoxianzaineijing1.5haomide8-12haochaoxiyinliuguan、bingrenjihuwugan;congyuanlaishoushuqianxianshu1600haoshengxue,daorujinquanchengchuxueliang50haosheng……waikeshoushudeweichuanghua,yiliaojishumeiyidianjinbu,188比分 meiyicidelinianshuaxin,douweijiasukangfuwaikedetuixingdiandinglejichu。”

十年之间,那些改变与收获

188比分zheixiejingrendebiange,haiyaocongshangshiji90niandaishuoqi。

188比分1997nian,jianyuouzhoupubiandelaolinghuashehuixianxiang、gaoangdeyiliaochengbenxianzhuang,danmaigebenhagendaxuehaweidefuyiyuanhenglike·kailejiaoshoulvxiantichulejiasukangfuwaikelinian(enhanced recovery after surgery,jianchengeras)。shizhizaiweishoushuqicaiyongyouxunzhengyixuezhengjudeyixilieyouhuacuoshi,yizuduanhuojianqingjitideyingjifanying,cujinhuanzheshuhoukuaisukangfu。

2007nian,eraslinianchuanruzhongguo,danbeijieshouhetuiguangqueshigexiangduihuanmandeguocheng。

188比分2010nian,guojierasxiehuizairuidianchengli。neiyinian,shirenlanzhoudaxuediyiyiyuanpuwaierkezhurenlixunzaiyuguoneiwaitongxingjiaoliushiminruidibuzhuodaolezheigexinxi。takaishizaipuwaike、gandanyijiweichangjibinglingyuzhubuchangshi,faxianxiaoguohenhao,bingrenshoushuchuangshanghezhuyuanshijiandoudadajiangdi。

188比分2015nian,lixundaiduilaidaoerasfayuandi——danmaigebenhagendaxuehaweidefuyiyuanxuexi。zaineili,takandaoerasyijingguifanquanmiandikaizhan,xiguanjiezhihuanshu、jiezhichangaigenzhishudengdaxingshoushuhuanzhedangtianjiunengzizhuxiadihuodong、jinshishui、jinxinggongnengduanlian,dangtianhuoshuhoudiertiandadaochuyuanbiaozhun,huidaojiazhonghuoshequjieshoujinyibukangfuduanlian;takandaoyinweierasdezhangqishishiyujilei,gaiyuanrijianshoushuzhongxingaoxiaoyunxing,puwai、guke、fuchandengxuekechangjianjibingshoushujibenshixianrijianshoushu,shuhouhuanzheduanzanhuifuhoujiukefanhuijiazhong。

huiguozhihou,zuoweifuyuanzhangyuwaikezhuanjia,tajuedingzaiyiyuanwaiketuixingeras,bingxiangdanmaihaweidefuyiyuantuoben·mogensenjiaoshoudengzhuanjiatuanduifachuyaoqing,meiniandingqi1-2cilaiyuanzhidaogongzuo。

2017年3月,托本·摩根森教授来兰州大学第一医院进行为期一周的学术交流

188比分tongshi,yiyuanjijiguli“zouchuqu、qingjinlai”。2010nianzhijin,yipaichu62mingyihu、guanlirenyuanchuguopeixun。tongshipinrenouzhoudingjiyiliaojigourijianshoushu、mazuixuezhuanjiadanrenkezuojiaoshou、erasyazhuanyezhidaojiaoshi。2018nian,jianyutuoben·mogensenjiaoshouzhangqiyilaiduilanzhoudaxuediyiyiyuannaizhigansushengyiliaoweishengshiyefazhanzuochudetuchugongxian,tabeishouyuzhongguozhengfuyouyijiang,shixibeiwushengweiyihuojiangdeyixuezhuanjia。

188比分2018-2019nian,yiyuanlianxujubanliangjie“lanzhouguojijiasukangfuyixuejirijianshoushugaofengluntan”;huopikejibugaoduanwaiguozhuanjiayinzhixiangmu——“jiasukangfuwaikeyujiasukangfuyixuezaiyiyuanzhenliaojiguanligongzuozhongdequanmiantuijin”;gulirijianshoushubingfangtuanduicanjiaquanguoyiyuanleitaisai,tijiaode“kuaisukangfuzhulirijianshoushu”congquanguo2196geanlizhongruxuanlezongjuesai。

鉴于兰州大学第一医院及李汛院长在实施、推广ERAS方面的努力与贡献,国际ERAS协会于2019年聘任李汛为中国区首位观察员会员

188比分guojierasxiehuituijinjihuazhuxi、ruishiluosangdaxuezhongxinyiyuannigulasi·demadinisijiaoshoubiaoshi: guoqushinian188比分 hezuofeichangyukuai。jiexialai,188比分 huishenruyugansu、lanzhoudaxuejilanzhoudaxuediyiyiyuandehezuo,weizaizhongguoxibuquanmiantuiguangshishierasfahuijijizuoyong。

188比分jinnian8yue18ri,lanzhoudaxuediyiyiyuanzuoweizhongguoshougejiamengyiyuanzhengshijiaruguojierasxiehui。

医护10分付出=患者0焦虑,0压力,0疼痛

188比分“eras,zheishigesha?nengduibingrenfudeqizheigezema?”yaodapojiwanggongzuoliucheng、fuchugengduojinglihexinlao、danfugengdazeren,henduoyihukaishidoubujieshou。

shenme?shuqian2xiaoshihainenghetangshui;shuhoubuxuyaokaolvpaiqijiunengjinshi;meiyoutongganzaozaojiunengxiachuangzoulu;dashoushusantianhoujiyuan……zheiyiqiedaodianquanbuanquan?zaimeiyoujinglizhiqian,xuduohuanzheyedouxincunyilv。

lanzhoudaxuediyiyiyuanyuanzhanglixunduicijieshi: ruguoshuoqiangjingjishushidewaikeshoushuweichuanghua,shi21shijiyixuezuizhongyaodejinbuzhiyi,neimeeraszeweiweishoushuqikangfudailailedianfuxingderenwenbiange。

maminjieyishiguanaishoushuweilijieshao: “yuanlaibingrenshuhouxuyaojingyangyizhou、fashengganranhebingfazhengjilvgao、shijitiancainengchidianxifan、quanxiusangeyue,erxianzaikeyizouchushoushushi、zuiwandiertianxiadi,chunianlaotiruohuanzhejihumeiyoubingfazheng,shuhoudiertianshuruchangneiwaiyingyangyebingjinliushi,wuliutianhuifudaozhengchangyinshi、hunsuyingyangquanshang,chuyuanshiqingtililaodongmeiyouwenti、sangeyuehuifudaoyuanlaidezhuangtai,feiyongyecongyuanlaide10duowanjiangdaole5-7wan,erasjiushizheimeshenqi。”

shenqidebeihoushiyihufuchudejudanuli。

zaierasliuchengzhong,waike、huli、mazuishizuizhongyaodesangehuanjie,kangfu、yingyang、yiyuanguanlishibibukeshaodebaozhang。

lanzhoudaxuediyiyiyuanjiasukangfuwaikeyujiasukangfuyixuetuanduimishu、mazuikefuzhurenjianmazuiyibuzhurenliuyataojiangerasjutishishihuafenweisangejieduan:

188比分shuqian: jiaqiangxuanjiao,ranghuanzhezhenzhengcanyuzhiliaohuliquanguocheng;zhidaoyinshi,yingyangzhichidiaojie;kaizhanyukangfu,lirujiaohuanzhexuehuiyouxiaoketan,tongguosuochunhuxi、chuiqiqiudengfangshiduanlianfeigongneng;chaoqianguifanzhentong;zhiliaohuanzhehebingjibing,youhuazangqigongnengdeng。

188比分shuzhong: waikeweichuanghuacaozuo,zaibaozhanganquanqiantixiabimianguoduoyinliuguan;mazuilianghaokongzhiyingjifanying,baohuhuanzhenao、xin、fei、shen、changdaodengzhongyaoqiguangongneng,duomoshiyufangshuhouexinoutuyuzhentongdeng。

shuhou: qianghuakangfuzhiliao,zaibaozhanganquanqiantixia,tichangzaoqixiachuanghuodongjizaoqichangneiyingyang。

“qizhongtebieqiangdiaodeshituanduihezuo,yihuanzheweizhongxin,yitishengweishuqianquanyuzhiliangweimubiaohegongzuohexin。birutengtongguanli,qiangdiaoduomoshizhentong、chaoqianzhentongyushaoliangapianleiyaowuzhentongyingguanchuanquanguocheng,shishigetihuazhentong,jiangzhiqiandeanxuzhitonggaiweiquanchengpinggu、anshizhitong。zuohaoleweishuqitengtongguanli,yejiuxianzhujiangdileshuhouexinoutufashenglv,gaishanleshuhouhuxi、changdaodengduoqiguangongnenghuifu。”liuyataoshuo。

huanzhechuleshoushushi,houxujiushihulituanduideshile。

“youshihou188比分 doujuedezijitingpopomamade,”chentingxiaoyan,“bujiantanyebuzouren;yibugandaopilaoweiyuanze,bingrenzhuanbugouquanshuyebuzouren,188比分 huigulibingrennapazaichuangbianzhanyizhan,yeshifeipaozengjialeyiciyundong;bingrenguanghexifanbuxing,baozi、jiaozi、miantiao、jirou、niurou、shuiguo、suannai,geyangdouyaochiyidian。”zheirangcongqianzhishuyedazhen、caozuoyiqishebeidehulirenyuanbujingongzuoliangdadazengjia,haibixushenjianduozhongjineng。jingliao、chuangkouguanli、huxigongneng、xinliganyudengduogegongnengxiaozu,yihuyitihualiandongchafang,shihulituanduixiaolvhezhuanyechengdudadatisheng。

chentinghetongshihaishejileshuhoukangfuliangbiao、xiongwaikeerashuanzheshujudengjibiao,congqunianxiabanniankaishiyilurule200duolishuju,yumazuikedengkeshigongxiang,gongzuokeyan、gongkenanguan。

bujinshixiongwaikeshixianleshiguanai、feiaishoushuhoubingrenzouchushoushushi,yiyuangandanyiwaiketuanduishishidejudaganaishoushu、fukedankongfuqiangjingshoushudengdeng,yeyouhuanzheanquan、zixindizouchushoushushi。90suiyishanggaolinghuanzheshanqixiubushuhou、guzheshuhoudangtianxiadi、santianchuyuanyebuzaixinxian。

188比分“zheijiuhaobi——buguanheimaobaimao,zhuazhulaoshujiushihaomao。”lixunshuo,“erqieyueshiweizhongdebingren,yueshifuzadeshoushu,yuexuyaozaieraslinianzhiyinxia,buduanyouhua,shigengduohuanzhehuoyi。”

从ERAS到ERAD,他们希望造福更多陇原百姓

188比分jiranzaiwaikelingyuxiaoguozheimehao,neimeerashainengyongzaishenmedifang?

针对老年病人在采用ERAD理念前后流程对比

2016niandi,jiyuerasdelianghaoshijian,lixunjinyibutichujiasukangfuyixueeradlinian(enhanced recovery after diseases): nenggoucujinyiyuangecengmian、gebumengoutongpeihe,zuizhongtishengzhenliaoanquan、zhiliangyuguanlixiaoneng,gaishanhuanzhejiuyitiyandehelihuacuoshi。muqian,yiyuanjiangeradjieraslieweizhongdiangongzuo,xieruyiyuan“shisiwufazhanguihua”。

188比分shishieras、erad,zaigansuhaiyouzheteshudeyiyi。

gansujingjishehuifazhanxiangduiluohou,xiaohuadaoaizhengzheiyangde“qiongbing”gaofa,henduojiatinghuiyinbingzhipin、yinbingfanpin。ruguonengjianshaohuanzhezhenliaoguochengzhongdebushibubian,jiangdiyiliaochengben,shilaodonglidedaokuaisuhuifu,neimewuyishijianyijuduodedehaoshi。

maminjiehaijidequnianyingzhuanglangxianrenminyiyuanyaoqing,weiyiwei83suidelaoyeyezuoleshidaoaishoushu。laorenjiashuhoudiertianxiadi、jinshi,feiyongyeshizaibenyuanzuodeyiban。yincixianyibaojugongzuorenyuanzaiduieraszezechengqidetongshiyeduitamendegongzuohaopingyoujia。kandaojicengdelaobaixinghuoyiliangduo,xiongwaikejuedingjiangweichuangshoushujieraslinianxiangguanjishuheshebeihaowubaoliudipeixuntuiguangzhigansuquanbuxianjiyiyuan。tashuo“188比分 nengzuodeshoushukendingshiyouxiande,gengzhongyaodeshixingchengzhiliangwendingdetixituiguangxiaqu,tishengxianjiyiliaofuwushuiping,zheiyuguojiachangdaodefenjizhenliaozhiduyefeichangwenhe。”

兰州大学第一医院医护赴基层指导实践ERAS

188比分yituogansushengmazuixuejinmixingzhuankelianmengjianshe、xiongwaikejinmixingzhuankelianmengjiansheyuzhikongzhongxindengpingtai,yiyuangexueketuanduiliyongzhoumo,shenrujicengtuiguangeras、eradlinianjigongzuojingyan,kaizhanshoubashoushijiao,shidaliangjicengyihuhehuanzhezaijiamenkoujiuganshoudaozuixinjishu、liniandailaidebiange。

2019nian,guojiaweijianweifabu《guanyukaizhanjiasukangfuwaikeshidiangongzuodetongzhi》,lanzhoudaxuediyiyiyuanhuopishoupishidianyiyuan。

lixunshuo: “188比分 deyoushihetesezaiyulizugansuxiangduipinkundexianzhuang,zhuiqiudebushikuai,ershizaianquandeqiantixiazuojingzuoyou,tongguofangfangmianmiandenuli、youhua,rangbingrenzuizhonghuoyi,zheiyeshikexuedejiazhisuozai。”

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文:法伊莎
图:高诗尧
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编辑:肖超元
责任编辑:许文艳

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