指南与共识丨肥胖代谢外科个案管理术前临床路径中国专家共识（2023版）

1. 院前咨询告知内容：个案管理师在患者进行院前咨询时，应充分告知手术适应证、禁忌证、手术方式、术后并发症等相关内容^[20-23]。见表1。

3. 院前床位预约：个案管理师应在患者入院前为其预约床位，并组建患者专属微信群以促进术前沟通及术后随访。见表3。

2. 检查、检验管理：患者入院后由专科医师开具必要的检查、检验项目，具体内容可能因患者情况或不同医疗中心差异存在不同，但其目的在于筛查手术风险指标，必要时开展多学科讨论^{[21, 24, 28, 33]}。个案管理师应协助患者完成各项检查、检验，及时追踪结果并与主管医师保持沟通，针对性动态评估患者需求并制订相关护理计划^[33-35]。见表5。

3. 临床照护：个案管理师在为患者提供临床照护的过程中承担多重职责，而目前肥胖代谢外科专职个案管理师人数与患者数量存在巨大差距，这限制并削弱个案管理师为患者提供临床照护的时间与精力^{[13, 15, 33]}。本专家共识推荐个案管理师与责任护士合作以利于提供高质量临床照护。个案管理师在指导实施护理计划时，应密切关注患者心理动态；临床护士应在加速康复理念指导下执行医嘱，适时为患者实施健康宣传教育，减轻患者顾虑的同时促进其快速康复^{[21, 23, 27, 36-38]}。见表6。

个案管理师作为照顾者、健康教育者、评估者及协调者，是肥胖代谢外科多学科团队的重要一员^[39]。随着肥胖代谢外科患者数量的增加，个案管理师人数应随之增长以满足临床需求。本专家共识针对个案管理术前临床路径形成一致性意见，制作范本文件，可为临床实践提供参考依据。后续将在进一步总结经验、累积循证医学证据后进行定期更新，以更好服务于临床。

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