基于加速康复外科理念的围手术期吸烟管理

吸烟和二手烟暴露严重危害人类健康,吸烟管理也是围手术期一个重要的公共卫生问题。吸烟患者术后呼吸系统、心血管系统并发症的发生率显著升高,烟草对术后疼痛控制、伤口愈合及术后康复指标均有不利影响。加速康复外科（enhanced recovery after surgery,ERAS）提倡通过充分的循征医学证据来优化围术期处理措施,减轻患者手术的应激反应,减少术后并发症,达到快速康复的目的。本文遵从加速康复外科理念,通过检索各国文献指南证据,对围手术期戒烟策略、戒烟时间及二手烟暴露处理和戒烟方法作一综述,为临床围手术期吸烟管理提供参考。

Application of enhanced recovery after surgery in smoking management during the perioperative period

Smoking and passive smoking are harmful to human health, and smoking management is a public health issue of particular importance during the perioperative period. The incidence of postoperative respiratory and cardiovascular complications was significantly higher in smoking patients, and tobacco had adverse effects on postoperative pain control, wound healing and postoperative rehabilitation indicators. Enhanced recovery after surgery(ERAS) advocated the use of sufficient evidence to optimize perioperative management measures, mitigate the stress response of patients, reduce postoperative complications, and achieve rapid recovery. Based on the concept of enhanced recovery after surgery, this article reviews the perioperative smoking cessation strategies, duration of smoking cessation, treatment of passive smoking exposure and methods of smoking cessation by searching the evidence of literature guidelines in various countries, so as to provide reference for clinical perioperative smoking management.