目的 比较加速康复外科（ERAS）联合绿色通道模式与常规急诊处置流程提升急诊断指再植救治的时效。方法 选择海军第971医院2021-01至2022-12急诊断指再植（非全身麻醉）患者80例,随机分为绿色通道组和常规组,每组40例。绿色通道组入院后经ERAS联合绿色通道模式救治至手术结束,常规组经急诊采用常规救治模式。观察两组术前准备时间（接诊至手术开始）,接诊时（T0）、术前准备时（T1）、麻醉时（T2）不同时点的生命体征及疼痛评分,以及再植成活情况及术后并发症。结果 绿色通道组术前准备时间（101.75±28.79）min,短于常规组的（142.13±41.24）min,差异有统计学意义（P<0.05）;绿色通道组T2时点VAS疼痛评分低于常规组[（4.23±1.31）vs.（6.63±1.63）];绿色通道组T1、T2时点收缩压以及舒张压均低于常规组,差异均有统计学意义（P<0.05）;其余各时点两组血氧、心率差异无统计学意义。两组再植成活率与术后并发症比较,差异无统计学意义。结论 ERAS联合绿色通道模式能够提高急诊断指再植患者救治时效,减轻麻醉疼痛,使围手术期血压更加平稳。

Objective To compare the improvement of the timeliness of emergency replantation treatment of severed fingers by enhanced recovery after surgery（ERAS）combined with green channel model and conventional emergency treatment procedure. Methods A total of 80 patients who underwent severed finger replantation in No.971 Hospital of PLA Navy from 2021 to 2022 were selected,and randomly divided into green channel group and conventional group,with 40 cases in each group. After admission,the green channel group was treated by ERAS combined with green channel mode until the end of surgery, while the s conventional group was treated with conventional mode in the emergency department. The preoperative preparation time（from admission to beginning of operation）,vital signs and visual analogue scale（VAS）at different time points during perioperative period including receiving（T0）, preoperative preparation（T1）, anaesthesia（T2） were observed in the two groups,and the successful replantation rate and postoperative complications were also documented. Results The preoperative preparation time of the green channel group [(101.75±28.79) min] was shorter than that of the conventional group（142.13 ± 41.24）minutes,and the difference was statistically significant（P<0.05）. The VAS pain score of the green channel group at time point T2（4.23 ± 1.31）was lower than that of the control group（6.63 ± 1.63）. The systolic and diastolic blood pressures at time points T1 and T2 in the green channel group were both lower than those in the conventional group, with significant differences（P<0.05）. There was no statistically significant difference in blood oxygen saturation and heart rate between the two groups at other time point. The successful replantation rate and postoperative complications between 2 groups showed no statistical difference. Conclusion ERAS combined with green channel model can improve the treatment timeliness of emergency patients with severed finger replantation,reduce the pain of patients during anesthesia,and make the perioperative blood pressure more stable.