《中华骨与关节外科杂志》2023年1月第16卷第1期Chin J Bone Joint Surg,VoL.16,No.1,Jan.2023·专家共识·脊柱结核手术加速康复外科实施流程专家共识中国康复医学会脊柱脊髓专业委员会感染学组，中国医师协会骨科医师分会脊柱感染学组【摘要】手术是脊柱结核的有效治疗方式之一。基于加速康复外科(ERAS)理念的脊柱结核手术可最大程度降低围手术期患者的生理与心理应，减少不良反应和手术并发症的发生。目前，针对脊柱结核手术尚无完整ERAS体系协助患者从术前、术中到术后加递康复。通过查阅文献，遵循循证医学原则，经过专家组反复讨论，针对脊柱结核手术患者围手术期管理达成共识，供广大医务工作者在临床工作中参考。本共识主要内容包括：脊柱结核手术的目的及围手术期ERAS进程的主要问题，术前宣教，术前评估，抗生素使用及皮肤准备，麻醉管理，手术时机及要点，围手术期血液管理，输液管理，疼痛管理，耐药脊柱结核的检测与管理，并发症的预防和处理，医用管路管理，术后康复训练及出院后管理。【关键词】加速康复外科；脊柱；结核；共识【中图分类号】R681.2:R493【文章编号】2095-9958(2023)01-0001-16【文献标志码】AD0t:10.3969/i.is3n.2095-9958.2023.01.01Expert consensus on implementation procedures for accelerated rehabilitation of spinaltuberculosis surgeryInfection Group,Spine and Spinal Cord Professional Committee of Chinese Rehabilitation Medical Association;Spinal InfectionGroup,Orthopaedic Branch of Chinese Physicians AssociationCorresponding Author:QIU Guixing,HAO Dingjun,HE Baorong[Abstract]Surgical treatment is one of the effective treatments for spinal tuberculosis.Spinal tuberculosis surgery based on theconcept of enhanced recovery after surgery (ERAS)can minimize perioperative physical and psychological stress of patients,andreduce the occurrence of adverse reactions and surgical complications.At present,there is no complete ERAS system for spinaltuberculosis surgery to help patients recover quickly before,during and after operation.Through consulting the literature,following theprinciple of evidence-based medicine and repeated discussions by the expert group,we reached a consensus on the perioperativemanagement of patients with spinal tuberculosis surgery,which can be used as a reference for medical staff in clinical work.The maincontents of this consensus included the purpose of spinal tuberculosis surgery and the main issues of perioperative ERAS process,preoperative education,preoperative comprehensive evaluation,antibiotic use and skin preparation,anesthesia management,operationtiming and key points,perioperative blood management,infusion management,pain management,detection and management of drug-resistant spinal tuberculosis,prevention and management of complications,medical pipeline management,rehabilitation exercise andpost-discharge management.[Key words]Enhanced Recovery After Surgery;Spine;Tuberculosis;Consensus加速康复外科(enhanced recovery after surgery,域包括胸腰椎创伤、颈椎前路手术、颈椎后路手术等ERAS)是基于生物-心理社会医学模式的理念，于围相继开展。为进一步推动ERAS在脊柱结核手术的手术期采取相应措施以减少应激及并发症的发生，开展，推广ERAS相关措施及认知，《脊柱结核手术加进而实现加速康复四。目前，ERAS已在脊柱外科领速康复外科实施流程专家共识》（下文简称“本共【基金项目】陕西省中医药管理局基础医学项目(2021-02-ZZ-016):陕西省科技厅科技成果转移与推广计划-获奖成果转化项目(2018CG-08)【通信作者】邱贵兴，E-mail:qguixing@126.com:郝定均，E-mail:hdgspine@163.comm:贺宝荣，E-mail:hebaorongspine@163.com【引用格式】中国康复医学会脊柱脊髓专业委员会感染学组，中国医师协会骨科医师分会脊柱感染学组.脊柱结核手术加速康复外科实施流程专家共识月.中华骨与关节外科杂志，2023,16(1)：1-16.
