ERAS理念下踝关节骨折诊疗方案优化的专家共识
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摘要
踝关节骨折是创伤骨科常见骨折之一。通过引入加速康复外科(enhanced recovery after surgery,ERAS)理念,对围手术期处理措施进行全面优化,可以进一步提高患者诊疗效果。为规范ERAS临床路径在踝关节骨折中的应用,基于前期研究经验,以循证医学证据为依据,经过全国专家组反复讨论,编制该专家共识,供全国创伤骨科医师在临床工作中参考。该共识适用于所有进行择期手术治疗的成人新鲜踝关节骨折患者。共识共包含25条推荐意见,就踝关节骨折患者急诊处理、术前准备、术中处理以及术后恢复进行了全面介绍。
Ankle fracture is one of the most common fractures in traumatic orthopedics. The introduction of Enhanced Recovery After Surgery(ERAS), optimizing perioperative protocols all sidedly, can further improve the quality of diagnosis and treatment. To improve the application of ERAS clinical pathway in ankle fracture treatment, based on preliminary experience and evidence-based medicine, we complied this expert consensus after repetitive discussion. This consensus contained 25 recommendations, including comprehensive introductions of emergency management, preoperative preparation, intraoperative treatment and postoperative recovery. It is applicable to all adult fresh ankle fracture patients undergoing selective operations.
Ankle fracture is one of the most common fractures in traumatic orthopedics. The introduction of Enhanced Recovery After Surgery(ERAS), optimizing perioperative protocols all sidedly, can further improve the quality of diagnosis and treatment. To improve the application of ERAS clinical pathway in ankle fracture treatment, based on preliminary experience and evidence-based medicine, we complied this expert consensus after repetitive discussion. This consensus contained 25 recommendations, including comprehensive introductions of emergency management, preoperative preparation, intraoperative treatment and postoperative recovery. It is applicable to all adult fresh ankle fracture patients undergoing selective operations.
引文
[1] Ljungqvist 0, Scott M, Fearon K C. Enhanced Recovery After Surgery:A Review. JAMA Surg, 2017,152(3):292-298.
[2] Ross A, Catanzariti AR, Mendicino RW. The hematoma block:a simple, effective technique for closed reduction of ankle fracture dislocations. J Foot Ankle Surg, 2011, 50(4):507-509.
[3] Rogers BA, Rang S. Intra-articular block compared with conscious sedation for closed reduction of ankle fracture-dislocations. A prospective randomized trial. J Bone Joint Surg Am, 2008,90(11):2549,2549-2550.
[4] Rowlands M, Walt GV, Bradley J, et al. Femoral Nerve Block Intervention in Neck of Femur Fracture(FINOF):a randomised controlled trial. BMJ Open, 2018, 8(4):e019650.
[5] Mcdonald S, Page MJ, Beringer K, et al. Preoperative education for hip or knee replacement. Cochrane Database Syst Rev, 2014,(5):CD003526.
[6]中华医学会外科学分会,中华医学会麻醉学分会.加速康复外科中国专家共识暨路径管理指南(2018).中华麻醉学杂志,2018,38(1):8-13.
[7] Enomoto TM, Larson D, Martindale RG. Patients requiring perioperative nutritional support. Med Clin North Am, 2013,97(6):1181-1200.
[8] Bozzetti F, Mariani L. Perioperative nutritional support of patients undergoing pancreatic surgery in the age of ERAS. Nutrition, 2014, 30(11-12):1267-1271.
[9]杨剑,许静涌,康维明,等.营养风险及营养风险筛查工具营养风险筛查2002临床应用专家共识(2018版).中华临床营养杂志,2018, 26(3)131-135.
[10] American Diabetes Association. Microvascular Complications and Foot Care. Sec. 10. In Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(Suppl. 1);S88-S98.Diabetes Care, 2017,40(7):986.
[11] Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting:an endocrine society clinical practice guideline. J Clin Endocrinol Metab, 2012, 97(1):16-38.
[12]中国住院患者血糖管理专家组中国医师协会内分泌代谢科医师分会.中国住院患者血糖管理专家共识.中华内分泌代谢杂志,2017, 33(1):1-5.
[13] Rohner-Spengler M, Frotzler A, Honigmann P, et al. Effective treatment of posttraumatic and postoperative edema in patients with ankle and hindfoot fractures:a randomized controlled trial comparing multilayer compression therapy and intermittent impulse compression with the standard treatment with ice. J Bone Joint Surg Am, 2014, 96(15):1263-1271.
[14] Keehan R, Guo S, Ahmad R, et al. Impact of intermittent pneumatic foot pumps on delay to surgery following ankle fracture. Foot Ankle Surg, 2013, 19(3):173-176.
[15] Giordano CP, Koval KJ. Treatment of fracture blisters:a prospective study of 53 cases. J Orthop Trauma, 1995, 9(2):171-176.
[16] Strauss EJ, Petrucelli G, Bong M, et al. Blisters associated with lower-extremity fracture:results of a prospective treatment protocol. J Orthop Trauma, 2006,20(9):618-622.
[17] Pelet S, Roger ME, Belzile EL, et al. The incidence of thromboembolic events in surgically treated ankle fracture. J Bone Joint Surg Am, 2012,94(6):502-506.
[18] Fleischer AE, Abicht BP, Baker JR, et al. American College of Foot and Ankle Surgeons'clinical consensus statement:risk, prevention, and diagnosis of venous thromboembolism disease in foot and ankle surgery and injuries requiring immobilization. J Foot Ankle Surg, 2015,54(3):497-507.
[19] Calder JD, Freeman R, Domeij-Arverud E, et al. Meta-analysis and suggested guidelines for prevention of venous thromboembolism(VTE)in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc, 2016,24(4):1409-1420.
[20] Griffiths JT, Matthews L, Pearce CJ, et al. Incidence of venous thromboembolism in elective foot and ankle surgery with and without aspirin prophylaxis. J Bone Joint Surg Br,2012,94(2):210-214.
[21] Smith MD, Mccall J, Plank L, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery.Cochrane Database Syst Rev, 2014,(8):D9161.
[22]李庭,周雁,孙旭,等.缩短创伤骨科择期手术患者围手术期禁食水时间的前瞻性队列研究.中华创伤骨科杂志,2018,20(4):312-316.
[23] Amer MA, Smith MD, Herbison GP, et al. Network metaanalysis of the effect of preoperative carbohydrate loading on recovery after elective surgery. Br J Surg, 2017, 104(3):187-197.
[24] Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration:Application to Healthy Patients Undergoing Elective Procedures:An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology, 2017, 126(3):376-393.
[25]吴新宝,余斌.创伤骨科围术期禁食水管理专家共识.中华创伤骨科杂志,2018, 20(9):1-6.
[26] Karason S, Olafsson TA. Avoiding bladder catheterisation intotal knee arthroplasty:patient selection criteria and lowdose spinal anaesthesia. Acta Anaesthesiol Scand, 2013, 57(5):639-645.
[27] Kreutziger J, Frankenberger B, Luger TJ, et al. Urinary retention after spinal anaesthesia with hyperbaric prilocaine 2%in an ambulatory setting. Br J Anaesth, 2010, 104(5):582-586.
[28] Lee S, Kim CH, Chung CK, et al. Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis. Spine J, 2017, 17(4):469-477.
[29] Altschul D, Kobets A, Nakhla J, et al. Postoperative urinary retention in patients undergoing elective spinal surgery. J Neurosurg Spine, 2017,26(2):229-234.
[30] Saint S, Trautner BW, Fowler KE, et al. A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters. JAMA Intern Med, 2018,178(8):1078-1085.
[31]抗菌药物临床应用指导原则修订工作组.抗菌药物临床应用指导原则(2015年版)[Z].国卫办医发[2015]43号附件,2015.
[32] Spruce L. Back to Basics:Pneumatic Tourniquet Use. AORN J, 2017,106(3):219-226.
[33] Bogdan Y, Helfet DL. Use of tourniquets in limb trauma surgery. Orthop Clin North Am, 2018, 49(2):157-165.
[34] Younger AS, Kalla TP, Mcewen JA, et al. Survey of tourniquet use in orthopaedic foot and ankle surgery. Foot Ankle Int, 2005,26(3):208-217.
[35] Odinsson A, Finsen V. Tourniquet use and its complications in Norway. J Bone Joint Surg Br, 2006, 88(8):1090-1092.
[36] Fitzgibbons PG, Digiovanni C, Hares S, et al. Safe tourniquet use:a review of the evidence. J Am Acad Orthop Surg, 2012,20(5):310-319.
[37] Luo J, Min S. Postoperative pain management in the postanesthesia care unit:an update. J Pain Res, 2017, 10:2687-2698.
[38] Elkassabany N, Cai LF, Mehta S, et al. Does regional anesthesia improve the quality of postoperative pain management and the quality of recovery in patients undergoing operative repair of tibia and ankle fractures? J Orthop Trauma, 2015,29(9):404-409.
[39] Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain:a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists'Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain,2016,17(2):131-157.
[40] Tuncali B, Karci A, Bacakoglu AK, et al. Controlled hypotension and minimal inflation pressure:a new approach for pneumatic tourniquet application in upper limb surgery.Anesth Analg, 2003, 97(5):1529-1532.
[41] Cestonaro T, Madalozzo SM, Thieme RD, et al. The reality of the surgical fasting time in the era of the ERAS protocol. Nutr Hosp, 2014, 29(2):437-443.
[42] Scott AV, Stonemetz JL, Wasey JO, et al. Compliance with surgical care improvement project for body temperature man-agement(SCIP Inf-10)is associated with improved clinical outcomes. Anesthesiology, 2015, 123(1):116-125.
[43] Toth MJ, Yoon RS, Liporace FA, et al. What's new in ankle fractures. Injury, 2017,48(10):2035-2041.
[44] Veltman ES, Halma JJ, de Gast A. Longterm outcome of 886posterior malleolar fractures:A systematic review of the literature. Foot Ankle Surg, 2016,22(2):73-77.
[45] Gardner MJ, Streubel PN, Mccormick JJ, et al. Surgeon practices regarding operative treatment of posterior malleolus fractures. Foot Ankle Int, 2011, 32(4):385-393.
[46] Sagi HC, Shah AR, Sanders RW. The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up. J Orthop Trauma, 2012, 26(7):439-443.
[47] Miller AN, Carroll EA, Parker RJ, et al. Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation. Clin Orthop Relat Res, 2010, 468(4):1129-1135.
[48]孙旭,李庭,孙志坚,等.三角韧带加强修补治疗合并三角韧带损伤及下胫腓分离的踝关节骨折.中华医学杂志,2018, 98(39):3192-3196.
[49]孙旭,李庭,孙志坚,等.骨折内固定术后是否放置引流管的前瞻性队列研究.中华创伤骨科杂志,2018,20(6):461-464.
[50] Weimann A, Braga M, Carli F, et al. ESPEN guideline:Clinical nutrition in surgery. Clin Nutr, 2017, 36(3):623-650.
[51]孙志坚,孙旭,孙伟桐,等.我国创伤骨科医生围手术期饮食管理现状调查.中华创伤骨科杂志,2018, 20(8):683-688.
[52] Bozimowski G. A review of nonsteroidal anti-inflammatory drugs. AANA J, 2015, 83(6):425-433.
[53] Capel M, Tornero J, Zamorano JL, et al. Efficiency of naproxen/esomeprazole in association for osteoarthrosis treatment in Spain. Reumatol Clin, 2014,10(4):210-217.
[54]梁廷波.加速康复外科理论与实践.北京:人民卫生出版社,2018:21.
[55] Koc M, Tez M, Yoldas 0, et al. Cooling for the reduction of postoperative pain:prospective randomized study. Hernia,2006,10(2):184-186.
[56] Apfel CC, Laara E, Koivuranta M, et al. A simplified risk score for predicting postoperative nausea and vomiting:conclusions from cross-validations between two centers. Anesthesiology, 1999,91(3):693-700.
[57]中华医学会麻醉学分会.成人手术后疼痛处理专家共识.临床麻醉学杂志,2017, 33(9):911-917.
[58]吴新民,罗爱伦,田玉科,等.术后恶心呕吐防治专家意见(2012).临床麻醉学杂志,2012, 28(4):413-418.
[59] Webber SC, Porter MM. Reliability of ankle isometric, isotonic, and isokinetic strength and power testing in older women.Phys Ther, 2010, 90(8):1165-1175.
[60] Simanski CJ, Maegele MG, Lefering R, et al. Functional treatment and early weightbearing after an ankle fracture:a prospective study. J Orthop Trauma, 2006, 20(2):108-114.
[61] Gustafsson UO, Oppelstrup H, Thorell A, et al. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery:a retrospective cohort study.World J Surg, 2016, 40(7):1741-1747.
[2] Ross A, Catanzariti AR, Mendicino RW. The hematoma block:a simple, effective technique for closed reduction of ankle fracture dislocations. J Foot Ankle Surg, 2011, 50(4):507-509.
[3] Rogers BA, Rang S. Intra-articular block compared with conscious sedation for closed reduction of ankle fracture-dislocations. A prospective randomized trial. J Bone Joint Surg Am, 2008,90(11):2549,2549-2550.
[4] Rowlands M, Walt GV, Bradley J, et al. Femoral Nerve Block Intervention in Neck of Femur Fracture(FINOF):a randomised controlled trial. BMJ Open, 2018, 8(4):e019650.
[5] Mcdonald S, Page MJ, Beringer K, et al. Preoperative education for hip or knee replacement. Cochrane Database Syst Rev, 2014,(5):CD003526.
[6]中华医学会外科学分会,中华医学会麻醉学分会.加速康复外科中国专家共识暨路径管理指南(2018).中华麻醉学杂志,2018,38(1):8-13.
[7] Enomoto TM, Larson D, Martindale RG. Patients requiring perioperative nutritional support. Med Clin North Am, 2013,97(6):1181-1200.
[8] Bozzetti F, Mariani L. Perioperative nutritional support of patients undergoing pancreatic surgery in the age of ERAS. Nutrition, 2014, 30(11-12):1267-1271.
[9]杨剑,许静涌,康维明,等.营养风险及营养风险筛查工具营养风险筛查2002临床应用专家共识(2018版).中华临床营养杂志,2018, 26(3)131-135.
[10] American Diabetes Association. Microvascular Complications and Foot Care. Sec. 10. In Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(Suppl. 1);S88-S98.Diabetes Care, 2017,40(7):986.
[11] Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting:an endocrine society clinical practice guideline. J Clin Endocrinol Metab, 2012, 97(1):16-38.
[12]中国住院患者血糖管理专家组中国医师协会内分泌代谢科医师分会.中国住院患者血糖管理专家共识.中华内分泌代谢杂志,2017, 33(1):1-5.
[13] Rohner-Spengler M, Frotzler A, Honigmann P, et al. Effective treatment of posttraumatic and postoperative edema in patients with ankle and hindfoot fractures:a randomized controlled trial comparing multilayer compression therapy and intermittent impulse compression with the standard treatment with ice. J Bone Joint Surg Am, 2014, 96(15):1263-1271.
[14] Keehan R, Guo S, Ahmad R, et al. Impact of intermittent pneumatic foot pumps on delay to surgery following ankle fracture. Foot Ankle Surg, 2013, 19(3):173-176.
[15] Giordano CP, Koval KJ. Treatment of fracture blisters:a prospective study of 53 cases. J Orthop Trauma, 1995, 9(2):171-176.
[16] Strauss EJ, Petrucelli G, Bong M, et al. Blisters associated with lower-extremity fracture:results of a prospective treatment protocol. J Orthop Trauma, 2006,20(9):618-622.
[17] Pelet S, Roger ME, Belzile EL, et al. The incidence of thromboembolic events in surgically treated ankle fracture. J Bone Joint Surg Am, 2012,94(6):502-506.
[18] Fleischer AE, Abicht BP, Baker JR, et al. American College of Foot and Ankle Surgeons'clinical consensus statement:risk, prevention, and diagnosis of venous thromboembolism disease in foot and ankle surgery and injuries requiring immobilization. J Foot Ankle Surg, 2015,54(3):497-507.
[19] Calder JD, Freeman R, Domeij-Arverud E, et al. Meta-analysis and suggested guidelines for prevention of venous thromboembolism(VTE)in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc, 2016,24(4):1409-1420.
[20] Griffiths JT, Matthews L, Pearce CJ, et al. Incidence of venous thromboembolism in elective foot and ankle surgery with and without aspirin prophylaxis. J Bone Joint Surg Br,2012,94(2):210-214.
[21] Smith MD, Mccall J, Plank L, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery.Cochrane Database Syst Rev, 2014,(8):D9161.
[22]李庭,周雁,孙旭,等.缩短创伤骨科择期手术患者围手术期禁食水时间的前瞻性队列研究.中华创伤骨科杂志,2018,20(4):312-316.
[23] Amer MA, Smith MD, Herbison GP, et al. Network metaanalysis of the effect of preoperative carbohydrate loading on recovery after elective surgery. Br J Surg, 2017, 104(3):187-197.
[24] Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration:Application to Healthy Patients Undergoing Elective Procedures:An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology, 2017, 126(3):376-393.
[25]吴新宝,余斌.创伤骨科围术期禁食水管理专家共识.中华创伤骨科杂志,2018, 20(9):1-6.
[26] Karason S, Olafsson TA. Avoiding bladder catheterisation intotal knee arthroplasty:patient selection criteria and lowdose spinal anaesthesia. Acta Anaesthesiol Scand, 2013, 57(5):639-645.
[27] Kreutziger J, Frankenberger B, Luger TJ, et al. Urinary retention after spinal anaesthesia with hyperbaric prilocaine 2%in an ambulatory setting. Br J Anaesth, 2010, 104(5):582-586.
[28] Lee S, Kim CH, Chung CK, et al. Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis. Spine J, 2017, 17(4):469-477.
[29] Altschul D, Kobets A, Nakhla J, et al. Postoperative urinary retention in patients undergoing elective spinal surgery. J Neurosurg Spine, 2017,26(2):229-234.
[30] Saint S, Trautner BW, Fowler KE, et al. A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters. JAMA Intern Med, 2018,178(8):1078-1085.
[31]抗菌药物临床应用指导原则修订工作组.抗菌药物临床应用指导原则(2015年版)[Z].国卫办医发[2015]43号附件,2015.
[32] Spruce L. Back to Basics:Pneumatic Tourniquet Use. AORN J, 2017,106(3):219-226.
[33] Bogdan Y, Helfet DL. Use of tourniquets in limb trauma surgery. Orthop Clin North Am, 2018, 49(2):157-165.
[34] Younger AS, Kalla TP, Mcewen JA, et al. Survey of tourniquet use in orthopaedic foot and ankle surgery. Foot Ankle Int, 2005,26(3):208-217.
[35] Odinsson A, Finsen V. Tourniquet use and its complications in Norway. J Bone Joint Surg Br, 2006, 88(8):1090-1092.
[36] Fitzgibbons PG, Digiovanni C, Hares S, et al. Safe tourniquet use:a review of the evidence. J Am Acad Orthop Surg, 2012,20(5):310-319.
[37] Luo J, Min S. Postoperative pain management in the postanesthesia care unit:an update. J Pain Res, 2017, 10:2687-2698.
[38] Elkassabany N, Cai LF, Mehta S, et al. Does regional anesthesia improve the quality of postoperative pain management and the quality of recovery in patients undergoing operative repair of tibia and ankle fractures? J Orthop Trauma, 2015,29(9):404-409.
[39] Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain:a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists'Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain,2016,17(2):131-157.
[40] Tuncali B, Karci A, Bacakoglu AK, et al. Controlled hypotension and minimal inflation pressure:a new approach for pneumatic tourniquet application in upper limb surgery.Anesth Analg, 2003, 97(5):1529-1532.
[41] Cestonaro T, Madalozzo SM, Thieme RD, et al. The reality of the surgical fasting time in the era of the ERAS protocol. Nutr Hosp, 2014, 29(2):437-443.
[42] Scott AV, Stonemetz JL, Wasey JO, et al. Compliance with surgical care improvement project for body temperature man-agement(SCIP Inf-10)is associated with improved clinical outcomes. Anesthesiology, 2015, 123(1):116-125.
[43] Toth MJ, Yoon RS, Liporace FA, et al. What's new in ankle fractures. Injury, 2017,48(10):2035-2041.
[44] Veltman ES, Halma JJ, de Gast A. Longterm outcome of 886posterior malleolar fractures:A systematic review of the literature. Foot Ankle Surg, 2016,22(2):73-77.
[45] Gardner MJ, Streubel PN, Mccormick JJ, et al. Surgeon practices regarding operative treatment of posterior malleolus fractures. Foot Ankle Int, 2011, 32(4):385-393.
[46] Sagi HC, Shah AR, Sanders RW. The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up. J Orthop Trauma, 2012, 26(7):439-443.
[47] Miller AN, Carroll EA, Parker RJ, et al. Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation. Clin Orthop Relat Res, 2010, 468(4):1129-1135.
[48]孙旭,李庭,孙志坚,等.三角韧带加强修补治疗合并三角韧带损伤及下胫腓分离的踝关节骨折.中华医学杂志,2018, 98(39):3192-3196.
[49]孙旭,李庭,孙志坚,等.骨折内固定术后是否放置引流管的前瞻性队列研究.中华创伤骨科杂志,2018,20(6):461-464.
[50] Weimann A, Braga M, Carli F, et al. ESPEN guideline:Clinical nutrition in surgery. Clin Nutr, 2017, 36(3):623-650.
[51]孙志坚,孙旭,孙伟桐,等.我国创伤骨科医生围手术期饮食管理现状调查.中华创伤骨科杂志,2018, 20(8):683-688.
[52] Bozimowski G. A review of nonsteroidal anti-inflammatory drugs. AANA J, 2015, 83(6):425-433.
[53] Capel M, Tornero J, Zamorano JL, et al. Efficiency of naproxen/esomeprazole in association for osteoarthrosis treatment in Spain. Reumatol Clin, 2014,10(4):210-217.
[54]梁廷波.加速康复外科理论与实践.北京:人民卫生出版社,2018:21.
[55] Koc M, Tez M, Yoldas 0, et al. Cooling for the reduction of postoperative pain:prospective randomized study. Hernia,2006,10(2):184-186.
[56] Apfel CC, Laara E, Koivuranta M, et al. A simplified risk score for predicting postoperative nausea and vomiting:conclusions from cross-validations between two centers. Anesthesiology, 1999,91(3):693-700.
[57]中华医学会麻醉学分会.成人手术后疼痛处理专家共识.临床麻醉学杂志,2017, 33(9):911-917.
[58]吴新民,罗爱伦,田玉科,等.术后恶心呕吐防治专家意见(2012).临床麻醉学杂志,2012, 28(4):413-418.
[59] Webber SC, Porter MM. Reliability of ankle isometric, isotonic, and isokinetic strength and power testing in older women.Phys Ther, 2010, 90(8):1165-1175.
[60] Simanski CJ, Maegele MG, Lefering R, et al. Functional treatment and early weightbearing after an ankle fracture:a prospective study. J Orthop Trauma, 2006, 20(2):108-114.
[61] Gustafsson UO, Oppelstrup H, Thorell A, et al. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery:a retrospective cohort study.World J Surg, 2016, 40(7):1741-1747.